IHCP Companion GuideS

This page contains IHCP Companion Guides for production version 4010A1 and testing version 5010.

HIPAA 4010 Companion Guides

This is a list of the HIPAA version 4010A1 IHCP Companion Guides for Production. The manuals contain interchange control structure and transaction specifications information. See the revision history for specific updates. Providers and EDI vendors developing software for electronic data interchange may need to view multiple guides. The IHCP Upcoming Companion Guide Changes are available on a separate page.

Name Date Updated
General Introduction December 2009
Communications Guide July 2005
Reports and Acknowledgements December 2009
270/271 Eligibility Benefit Transaction December 2009
276/277 Claim Status Request and Response Transaction December 2009
278 Prior Authorization Review Request and Response Transaction March 2007
820 HIP Capitation Payment Transaction December 2010
820 MCE Capitation Payment Transaction March 2011
834 HIP Benefit Enrollment and Maintenance Transaction November 2011
834 MCE Benefit Enrollment and Maintenance Transaction - Hoosier Healthwise and Care Select November 2011
834 MCE Benefit Enrollment and Maintenance Transaction - Presumptive Eligibility November 2011
835 Remittance Advice Transaction December 2009
837 Dental Claims Transaction December 2009
837 Professional Claims and Encounters Transaction December 2009
837 Professional Claims Transaction - Healthy Indiana Plan (HIP) December 2009
837 Institutional Claims and Encounters Transaction March 2011
837 Institutional Claims Transaction - Healthy Indiana Plan (HIP) December 2009
HIP Post Adjudication Payer Sheet December 2009
NCPDP 1.1 & 5.1 Transaction Payer Sheet December 2009

HIPAA 5010 Companion Guides

and NCPDP d.0 Payer Sheet

This is a list of the HIPAA version 5010 IHCP Companion Guides to be used for upgrading to version 5010. The guides contain structure and transaction specifications. The IHCP Companion Guide Overview and the IHCP Notes provide Indiana Medicaid specific information. See the revision history document for specific updates. Providers and EDI vendors developing software for electronic data interchange may need to view multiple guides. The IHCP Upcoming Companion Guide Changes are available on a separate page.

Name Date Updated
999 Acknowledgement and Submission Summary Report Guide V1.0 November 2011
270 Eligibility Coverage or Benefit Inquiry Transaction 5010 V1.1 August 2011
271 Eligibility Coverage or Benefit Information Transaction 5010 V1.2 February 2012
276 Health Care Claim Status Request Transaction 5010 V1.0 December 2010
277 Health Care Information Status Notification Transaction 5010 V1.0 December 2010
278 Health Care Services Prior Authorization Review Request  Transaction 5010 V1.0 December 2010
278 Health Care Services Prior Authorization Review Response Transaction 5010 V1.0 December 2010
820 MCE Capitation Payment Information Transaction 5010 V1.1 March 2011
834 MCE Benefit Enrollment and Maintenance Transaction 5010 V1.3 November 2011
835 Health Care Claim Payment/Advice Transaction 5010 V1.1 August 2011
837D Health Care Claim: Dental Transaction 5010 V1.1 August 2011
837I Health Care Claim: Institutional Transaction 5010 V1.2 August 2011
837P Health Care Claim: Professional Transaction 5010 V1.2 August 2011
NCPDP D.0 and 1.2 Transaction Payer Sheet V2.0 November  2011