IHCP identifies processing error for Hoosier Healthwise dental
The Indiana Health Coverage Programs (IHCP) announced in
BT201678, that effective January 1, 2017, the management of dental
benefits for members enrolled in Hoosier Healthwise would
transition to the managed care entities (MCEs). Each MCE, along
with any contracted dental benefit manager (DBM), would manage
Hoosier Heathwise dental benefits and process dental claims.
Accordingly, Hoosier Healthwise dental claims for dates of service
(DOS) on or after January 1, 2017, would no longer be processed by
Hewlett Packard Enterprise (HPE).
The IHCP has identified that Hoosier Healthwise claims for
certain dental codes, for DOS on or after January 1, 2017, that
were submitted in error to HPE continued to process and pay. On
Tuesday, January 10, 2017, this claims processing error was
corrected. Any claims processed by HPE after that date should
Dental providers whose claims for Hoosier Healthwise members
that were processed in error by HPE - regardless of a denied or
paid status - should void the claims and resubmit the claims to the
appropriate MCE/DBM. Providers are advised to take this action as
soon as possible to avoid issues of timely filing with the MCE/DBM.
See BT201678 for
contact information for MCEs and DBMs.
All Hoosier Healthwise dental claims for DOS on or after January
1, 2017, that are not voided will be systematically mass adjusted
and denied by HPE at a later date. The IHCP will give providers at
least 30 days' notice prior to processing the mass adjustment. All
payments made for voided and adjusted claims will be recouped as
accounts receivable. Providers should contact their HPE provider
field consultant to discuss the recoupment process.