Electronic Data Interchange (EDI) Solutions

The following links relay important information to all providers and software developers that communicate via Electronic Data Interchange (EDI) format and Direct Data Entry (DDE).

The "providers" links are intended for Indiana Health Coverage Programs (IHCP) providers. The "EDI vendors" links are addressed to clearinghouses, billing services, managed care organizations (MCO), valued-added network (VAN), and software developers. Helpful hints are for both providers and EDI vendors.

Information about the submission of National Provider Identifier (NPI) can be found in the IHCP Companion Guides and the What's New for EDI Vendors documents.

For providers

Provider EDI Implementation Procedures Step-by-step procedures for becoming a trading partner with the IHCP.
IHCP Trading Partner Profile Form required for trading partner setup.
IHCP Trading Partner Agreement Agreement required for trading partner setup.
IHCP-Approved Software Developers - 5010 Contact list of all software vendors and clearinghouses approved for version 5010 transactions.
Web interChange Alternative means for IHCP providers to perform direct data entry (DDE) functions.
Medicare Payer ID List List of Contractor Payer IDs for Medicare Part A, Medicare Part B, and durable medical equipment regional carrier (DMERC) Medicare crossover claims.

For EDI vendors

What's New for EDI Vendors Information about upcoming IHCP system updates, release dates, internal and external impacts, and Upcoming Companion Guide Changes identifying modifications, known issues, corrections, and common compliance errors.
Software Testing Procedures Step-by-step procedures for EDI vendors that have not yet been approved by the IHCP.
IHCP Companion Guides Production versions of the Companion Guides.
EDI Vendor Testing Timeline Timeline allowed for EDI vendors to make system modification for upcoming enhancements.
ICD-10 Testing Page - Software and Clearinghouse Vendors Useful information for software and clearinghouse vendors regarding vendor testing for the implementation of ICD-10.

Helpful hints

Common Compliance Errors Most common reasons why transactions are failing compliance and how to correct.
Frequently Asked Questions (FAQs) Answers to the most frequently asked HIPAA/X12 format questions.
Billing of Crossover Claims Directly to the IHCP Contains instructions for billing claims to the IHCP for dually eligible members that are initiated by the provider.
837 Billing of TPL Claims
Contains instructions for billing claims to the IHCP with third-party liability (TPL) coverage.

The IHCP support help desk for EDI can be contacted at (317) 488-5160, 1-877-877-5182 or via email at INXIXTradingPartner@hp.com.