Indiana Health Coverage Programs Update

The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at indianamedicaid.com on February 28, 2017 (unless alternate date is noted).

The Indiana Health Coverage Programs (IHCP) posted the following important information to the provider website at indianamedicaid.com on February 28, 2017 (unless alternate date is noted).
 
Bulletins and Banner Pages

BT201718 - IHCP notifies HCBS providers of inappropriate TPL reclamation process for HCBS claims

BT201717 - Changes to fee-for-service pharmacy benefit reimbursement methodology

BT201716 - Pharmacy update approved by Drug Utilization Review Board February 2017

BR201709

• IHCP will mass adjust waiver claims that denied incorrectly
  
• IHCP clarifies Provider Healthcare Portal prior authorization status codes
  
• IHCP will mass reprocess institutional crossover claims that denied incorrectly
  
• Delegates must have Provider Maintenance access to add or remove rendering providers
  
• IHCP clarifies which provider types should use their Provider ID for billing purposes
  
• IHCP reminds providers attesting for the EHR Incentive program they must register as rendering providers in the Portal
  
• All rendering providers who enrolled in the IHCP before 2017 display a default address of "Indianapolis" in the Portal
  
• IHCP will mass adjust claims with details that denied incorrectly due to manual pricing

 
Provider Reference Modules

Electronic Data Interchange

• Edited and reorganized text for clarity
  
• Replaced Web interChange references with Provider Healthcare Portal
  
• Replaced Automated Voice Response (AVR) system reference with Interactive Voice Response (IVR) system
  
• Added the Introduction section
  
• Removed references to Delivery and Support System (DASS) in the Connectivity Options section
  
• Updated the EDI Solutions help desk telephone number
  
• Added the 820 Payroll Deducted and Other Premium Payment (Managed Care Entities Capitation Payment) section
  
• Added the 834 Benefit Enrollment and Maintenance (Managed Care Entities) section
  
• Updated the 835 Health Care Claim Payment/Advice section
  
• Added note about submitting pharmacy claims in the 837 Health Care Claim section
  
• Updated the 999 Acknowledgement for Health Care Insurance section
  
• Removed the Submission Summary Report section
  
• Added the TA1 Interchange Acknowledgement section
  
• Updated the EDI Trading Partner Process section
  
• Added use of an IHCP-approved billing service to the list of methods of exchanging data with the IHCP that are exempt from the trading partner requirement
  
• Removed references to value-added networks (VANs)
  
• Updated the Complete a Trading Partner Agreement section
  

Medical Practitioner Reimbursement

• Changed Web interChange to Provider Healthcare Portal (Portal)
  
•  Updated billing instructions to encompass Portal billing
  
• Changed LPI reference to Provider ID
  
• Changed IndianaAIM reference to CoreMMIS
  
• Removed information about ordering a printed Fee Schedule from the Introduction section
  
• Added bilateral surgery billing and reimbursement procedures and updated the description for modifier 78 in the Surgery-Related Modifiers Affecting Payment section
  
• Added the Provider Preventable Conditions subheading
  

​
590 Program 

• Changed AVR references to IVR
• Changed Web interChange references to Provider Healthcare Portal (Portal)
• Changed IndianaAIM references to CoreMMIS
• Added contact information for Cooperative Managed Care Services (CMCS)
• Made updates to the New Admissions without Existing Enrollment in the IHCP section

 
Code Table and Other Updates
The following updated code tables are now available on the Code Sets page:

• CMS-1500 Modifiers
  
• Reviewed and updated table as needed

 
Check out these resources to stay up-to-date with the most recent changes at the IHCP.

We hope you find this information useful. If you have any questions, please contact the INARF office.