Have you ever wondered how a hospital, hospice care, or dentist became an Indiana Medicaid Provider?  Well, I have, so I decided to research the process.  The process for all providers begins with accessing www.indianamedicaid.com.  All information and forms needed to become an Indiana Medicaid Provider are listed in detail on the website.

Benefits to being an Indiana Medicaid Provider:

Indiana Medicaid providers can

  • Increase clients or panel size
  • Have full control of the number of Medicaid patients seen
  • Improve the health of low-income children and families
  • Have access to fast and accurate claims processing
  • Receive personalized training for billing practices and help in submitting claims
  • Have free access to Web InterChange for online claims processing
  • Access customer assistance call center, getting one-on-one answers to questions and concerns 10 hours a day, five days a week.

Process to becoming an Indiana Medicaid Provider:

Step one:

A provider is required to complete an Indiana Health Coverage Program (IHCP) Provider Packet.  There are different packets for different types of providers.  Each type of provider has a category code. For example 01 is for a Hospital, 08 for a Hospice, 22 is for a hearing aid dealer, and 27 is for a Dentist.

Applications are classified by category codes, and different providers have certain information that needs to be provided to the State of Indiana.  Enrollment packets have between 30-50 pages of instructions and forms.  Included in the packets are checklists, bank information request, location and owner information, request for certifications and licenses, organizational structure, provider agreement, and IRS forms.  Providers in high Screening Risk Categories also have an application fee.  High Screening Risk Category providers include clinics, labs, suppliers, dealers, dentists, hearing aid suppliers, and transportation providers.

Applications are then mailed to the State of Indiana.

Step 2:

At least 20 business days are allowed for mailing and processing before providers should check on the status of their submission. After the transaction is processed, the HP Provider Enrollment Unit will notify the provider of the results.

If the packet needs correcting or is missing required documentation, the HP Provider Enrollment Unit will contact the provider by telephone, email, fax, or mail. This contact is intended to communicate what needs to be corrected, completed, and submitted before the IHCP can process the enrollment transaction.

If the packet is complete, HP will process the transaction and conduct the appropriate screening associated with the provider’s assigned risk level.

If the IHCP denies enrollment or re-validation, the provider will receive a notification letter explaining the denial reason. If the provider believes the enrollment or re-validation was denied in error, they may appeal.

Information provided from www.indianamedicaid.com