Manuals

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Providers may access or download copies of manuals from this website. NOTE: If you have trouble opening linked PDF files, please view the PDF Help page.

Medical Policy Manual

Name Effective Date Current
Version
Medical Policy Manual December 2014 Version 2.0

IHCP Provider Manual

Section Name Effective Date Current Version
IHCP Provider Manual Cover Page N/A N/A
Chapter 1: General Information July 1, 2014 Version 14.1
Chapter 2: Member Eligibility and Benefit Coverage July 1, 2014 Version 14.1
Chapter 3: Electronic Solutions September 1, 2014 Version 14.1
Chapter 4: Provider Enrollment, Eligibility, and Responsibilities August 1, 2014 Version 14.1
Chapter 5: Third Party Liability October 1, 2014 Version 14.1
Chapter 6: Prior Authorization April 1, 2014 Version 14.0
Chapter 7: Reimbursement Methodologies April 1, 2014 Version 14.0
Chapter 8: Billing Instructions May 1, 2014 Version 14.0
Chapter 9: IHCP Pharmacy Services Benefit June 1, 2014 Version 14.0
Chapter 10: Claims Processing Procedures October 1, 2014 Version 14.1
Chapter 11: Paid Claim Adjustment Procedures December 1, 2014 Version 14.1
Chapter 12: Financial Services June 1, 2014 Version 14.0
Chapter 13: Utilization Review August 1, 2014 Version 14.1
Chapter 14: Long-Term Care
July 1, 2014 Version 14.1
Index N/A N/A

Supplemental Provider MANUALS

Title
Revision Date Current Version
590 Program Provider Manual
July 1, 2014 Version 9.1
Division of Aging Home and Community-Based Services Waiver Provider Manual
November 1, 2014 Version 2.1
Division of Disability and Rehabilitative Services Home and Community-Based Services Waiver Provider Manual
June 1, 2014 Version 2.0
Division of Mental Health and Addiction Behavioral and Primary Healthcare Coordination Program Provider Manual
October 1, 2014
Version 1.0
Division of Mental Health and Addiction Psychiatric Residential Treatment Facility Transition Waiver Provider Manual
July 1, 2014 Version 2.1
HealthWatch/EPSDT Manual
April 1, 2014 Version 10.0
HIP Reimbursement Manual
May 1, 2014 Version 5.0
Hospice Provider Manual
May 1, 2014 Version 12.0
Hospital Presumptive Eligibility Qualified Provider Manual
August 1, 2014 Version 1.1
Medicaid Rehabilitation Option (MRO) Provider Manual
June 1, 2014 Version 10.0
Presumptive Eligibility for Pregnant Women Qualified Provider Manual
April 1, 2014 Version 6.0
Right Choices Program Policy Manual
August 1, 2014 Version 5.1

Other resources

Title
Revision Date Current Version
IHCP Companion Guides (electronic transactions, HIPAA version 2010)
See link N/A
IHCP Common Glossary
June 2010 N/A

 

 

(electronic transactions, HIPAA version 5010[Hoffmeyer1] )[dwm2]

[Hoffmeyer1]The Companion Guides are posted in the EDI section of the website.

 

DWM-there are dates associated with the guides so let's change "N/A" "See link"

[dwm2]Add this explanatory reference so providers know what these are? OR "(electronic transactions)"?

 

Per 1/8/15 conversation with Marcia Reed: Use both!