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The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at indianamedicaid.com on January 16, 2018 (unless alternate date is noted). Bulletins and Banner Pages BR201803 - IHCP to cover HCPCS code Q2043 - IHCP to mass adjust or mass reprocess claims for certain ocular implant DME codes that may have denied inappropriately Provider Reference Modules (posted January 11, 2018)
Interactive Voice Response System - Changed Hewlett Packard Enterprise references to DXC Technology - Added ICN to Claim ID references - Added EFT along with check payment in the Introduction section - Added response limitation for PA requests and removed response limitation for PMP assignments in the IVR System Limitations section - Added taxonomy format as an error option in Table 4 - Changed “office location” to “service location” in IVR System Walkthrough - Updated steps 1a, 1b, 1c, and 3 (Table 7), including adding options and updating option numbers in the initial greeting - Updated steps 5-0 and 5-5 (Table 8) - Added a note to step 5-7 (Table 8) about the system not providing the Member ID unless the provider entered it - Removed the note in step 5-8c (Table 9) regarding IVR response limitations for PMP assignment - Corrected the telephone option number for TPL in the Other Insurance Information section - Corrected step 9-10a (Table 16) to remove reference to the amount billed Out-of-State Providers - Edited text for clarity - Added a note box referring providers to the Medical Policy Manual for policy information - Updated the Introduction section: - Added a reference to the IHCP Provider Enrollment Type and Specialty Matrix for out-of-state provider eligibility and documentation requirements - Included information about retroactive enrollment for out-of-state providers - Removed the Service Coverage section - Updated the Prior Authorization for Out-of-State Services section: - Clarified PA requirements for services rendered in out-of-state areas designated as “in state” - Removed references to wards of the court - Clarified that out-of-state services provided to members of the Adoption Assistance Program placed out of state still require PA, although all routine medical and dental services are approved for these members - Clarified that DME and HME providers that have a business office in Indiana are treated the same as in-state providers for PA - Clarified out-of-state DME and HME PA requirements in the Out-of-State Suppliers of Medical Equipment section - Updated the Service Restrictions section, including replacing the bullet about provider types not eligible for IHCP enrollment with a reference to the IHCP Provider Enrollment Type and Specialty Matrix - Updated the Reimbursement Rates for Out-of-State Providers section Telemedicine and Telehealth Services - Edited and reorganized text as needed for clarity - Added a note box to the Telemedicine Services section explaining that standard restrictions and limitations apply to services when delivered as telemedicine - Updated the Excluded Provider Types and Services section - Updated the Hub Site Services and Billing Requirements section: - Removed “individual” from the psychotherapy bullet - Specified Professional for the Fee Schedule reference - Added information about modifier 95 - Added modifier 95 information to the Spoke Site Services and Billing Requirements section - Updated the Telemedicine Services for FQHCs and RHCs section: - Updated the M&S website link - Removed extraneous information, including PPS rate information, (and changed billable/ nonbillable to reimbursable/nonreimbursable) 590 Program - Edited and reorganized text as needed for clarity - Changed Hewlett Packard Enterprise references to DXC Technology - Changed RID references to Member ID - Updated the Facility and Provider Enrollment Information section and its subsections, including: - Added a reference to the Provider Enrollment module - Added information about out-of-state providers - Added Provider Healthcare Portal as an enrollment option - Changed LPI references to IHCP Provider ID - Updated the text and table in the 590 Program Contractors and Resources section - Updated the Verifying 590 Program Enrollment section, including: - Added 270/271 transactions as eligibility verification option - Removed reference to the EVS systems being down for routine maintenance between 4 a.m. and 5 a.m. - Expanded and updated the Prior Authorization for the 590 Program section - Updated where to mail claims and clarified which modules contain filing-limit information in the Claim Submission section - Updated the Third-Party Liability and Medicare section: - Updated the name and number of the EDT form (per current form) - Clarified that faxing is an option and updated the fax number for the TPL Unit - Updated the fax number for submitting the EDT form in the Member Eligibility and Enrollment section - Removed references to former enrollment/coverage in the New Admissions Without Existing Enrollment in the IHCP section - Updated information in the Currently Enrolled IHCP Members section and its subsections, including correcting the fax number for CMCS-RCP - Updated the eligibility analyst contact number in the Discharges and Deaths of 590 Program Members section - Updated Figure 1 – FSSA OMPP Agreement Between 590 Facilities and OMPP with current form - Updated Figure 2 – Enrollment/Discharge/Transfer (EDT) State Hospitals and 590 Program Form with current form Check out these resources to stay up-to-date with the most recent changes at the IHCP. 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