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 July 2015 Version 2.1

IHCP Provider Manual

Section Name Effective Date Current Version
IHCP Provider Manual Cover Page N/A N/A
Chapter 1: General Information January 1, 2015 Version 15.0
Chapter 2: Member Eligibility and Benefit Coverage February 1, 2015 Version 15.0
Chapter 3: Electronic Solutions January 1, 2015 Version 15.0
Chapter 4: Provider Enrollment, Eligibility, and Responsibilities January 1, 2015 Version 15.0
Chapter 5: Third Party Liability January 1, 2015 Version 15.0
Chapter 6: Prior Authorization January 1, 2015 Version 15.0
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 February 1, 2015 Version 15.0
Chapter 10: Claims Processing Procedures January 1, 2015 Version 15.0
Chapter 11: Paid Claim Adjustment Procedures January 1, 2015 Version 15.0
Chapter 12: Financial Services January 1, 2015 Version 15.0
Chapter 13: Utilization Review January 1, 2015 Version 15.0
Chapter 14: Long Term Care
January 1, 2015 Version 15.0
Index N/A N/A

Supplemental Provider MANUALS

Title
Effective Date Current Version
590 Program Provider Manual
January 1, 2015 Version 10.0
Division of Aging Home and Community-Based Services Waiver Provider Manual
May 1, 2015 Version 3.0
Division of Disability and Rehabilitative Services Home and Community-Based Services Waiver Provider Manual
December 1, 2014 Version 2.2
Division of Mental Health and Addiction Behavioral and Primary Healthcare Coordination Program Provider Manual
April 1, 2015
Version 2.0
Division of Mental Health and Addiction Psychiatric Residential Treatment Facility Transition Waiver Provider Manual
January 1, 2015 Version 3.0
HealthWatch/EPSDT Manual
April 1, 2015 Version 11.0
HIP Reimbursement Manual
February 1, 2015 Version 6.0
Hospice Provider Manual
May 1, 2015 Version 13.0
Hospital Presumptive Eligibility Qualified Provider Manual
February 1, 2015 Version 2.0
Medicaid Rehabilitation Option (MRO) Provider Manual
May 1, 2015 Version 11.0
Presumptive Eligibility for Pregnant Women Qualified Provider Manual
November 1, 2014 Version 6.1
Presumptive Eligibility Qualified Provider Manual April 1, 2015 Version 1.0
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 5010)
See link 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!

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