Complete an IHCP Provider Enrollment Application. To receive notices, you must subscribe. Copyright 2022 State of Indiana - All rights reserved. Vision and dental care. CareSource Medicaid members get access to a large provider network, State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. Providers can contact the Indianapolis Marriott East directly at reservations@indymarriotteast.com should they have issues with guest room reservations. The Indiana Health Coverage Programs (IHCP) invites providers to attend the 2022 IHCP Works seminar from Oct. 11 through Oct. 13. Our dental providers can access the following tools to help them provide efficient and quality care. HIP Plus members pay a monthly PAC based on income and family size. Whether you're new to Medicaid or have been a provider for years, this section is designed to help answer your billing questions. Click here for a comparison of the available health plans. What are the incentives for managing costs and receiving preventive care? Contribution amounts may be higher for smokers. HIP Basic can be more expensive than HIP Plus. There will be new individual and provider portals that will look and act differently. Enrollment transaction submissions are needed to enroll, add a service location, report a change of ownership, revalidate, or update provider profile information. Managing your account well and getting preventive care can reduce your future costs. Pregnant and new moms can earn up to $200 in rewards for keeping prenatal and well-baby visits. Indiana Medicaid provides a healthcare safety net to Hoosier children, aged, disabled, pregnant women, and other eligible populations under the umbrella of Indiana Health Coverage Programs (IHCP). Help finding a job, finishing your degree or exploring a new career path with CareSource Life Services . Click here to access a calculator that will help you determine if you are eligible for HIP and will estimate your monthly POWER account contribution. CareSource wants to ensure our providers have easy access to the latest tools and resources regarding COVID-19. There are two PDLs, depending on which plan you have. Georgia Medicaid members who are employed may be eligible for health insurance premium assistance through a Medicaid program called the Health Insurance Premium Payment Program (HIPP). Medicaid Behavioral/Physical Health Coordination, Medical Clearance Forms and Certifications of Medical Necessity, Agreement Between 590 Facilities and the OMPP, Enrollment/Discharge/Transfer (EDT) State Hospitals and 590 Program State Form 32696 (R3/2-16)/OMPP 0747, Provider Authorization [590 Program membership information for outside the 590 Program facility] State Form 15899 (R5/10-18)/OMPP 2021, Consent for Sterilization HHS-687 (04/22), Consentimiento para la esterilizacin (Consent for Sterilization Spanish version) HHS-687-1 (04/2022), IHCP Third-Party Liability (TPL)/Medicare Special Attachment Form, IHCP Third-Party Liability (TPL)/Medicare Special Attachment Form Instructions, IHCP Professional, Dental, or Medicare Part B Crossover Claim Adjustment Request, IHCP Institutional and Inpatient/Outpatient Crossover Adjustment Request, IHCP Electronic Funds Transfer Addendum/Maintenance Form, Find Anthem Healthy Indiana Plan forms at anthem.com, Find CareSource Healthy Indiana Plan forms at caresource.com, Find MDwise Healthy Indiana Plan forms at mdwise.org, Find Managed Health Services Healthy Indiana Plan forms at mhsindiana.com, Find Anthem Hoosier Care Connect forms at anthem.com, Find Managed Health Services Hoosier Care Connect forms at mhsindiana.com, Find UnitedHealthcare Hoosier Care Connect forms at uhcprovider.com, Find Anthem Hoosier Healthwise forms at anthem.com, Find CareSource Hoosier Healthwise forms at caresource.com, Find MDwise Hoosier Healthwise forms at mdwise.org, Find Managed Health Services Hoosier Healthwise forms at mhsindiana.com, Change in Status of Medicaid Hospice Patient Form, Hospice Accounts Receivable Refund Adjustment Form, Hospice Authorization Notice for Dually Eligible Medicare/Medicaid Nursing Facility Residents Form, Hospice Provider Change Request Between Indiana Hospice Providers Form, Eleccin del hospital (Medicaid Hospice Election Form Spanish version), Medicaid Hospice Physician Certification Form, Medicaid Hospice Plan of Care for Curative Care Members 20 Years and Younger, Certification of the Need for Inpatient Psychiatric Hospital Services (State Form 44697 (R4/5-15)/OMPP 1261A), Enrollment/Discharge/Transfer (EDT) State Hospital and 590 Program (State Form 32696 (R3/2-16)/OMPP 0747), Indiana Medicaid Hospital Request for Settlement: Suspect Child Abuse and Neglect Cases, Certification Statement by Medicaid-Enrolled Nursing Facilities, Nursing Home Fax Procedures to Obtain Medicare Prescription Drug Plan Enrollment Information for Multiple Residents, Medicaid Behavioral/Physical Health Coordination Form State Form 51856 (R2/12-04)/OMPP 0016, Augmentative Communication System Selection Form, Certification of Medical Necessity: CMS-484 Oxygen, DME Information Form CMS-10126 Enteral and Parenteral Nutrition, Medical Clearance and Audiometric Test Form (the medical clearance form for hearing aids, Medical Clearance Form for Hospital and Specialty Beds, Medical Clearance Form for Motorized Wheelchair Purchase, Medical Clearance Form for Negative Pressure Wound Therapy, Medical Clearance Form for Nonmotorized Wheelchair Purchase, Medical Clearance Form for Standing Equipment, Medical Clearance Form for TENS (Transcutaneous Electrical Nerve Stimulator) Unit, IHCP Prior Authorization Request Form (universal PA form), IHCP Prior Authorization Request Form Instructions, IHCP Prior Authorization - System Update Request Form, IHCP Dental Prior AuthorizationRequest Form, IHCP Dental Prior AuthorizationRequest Form Instructions, IHCP Residential/Inpatient Substance Use Disorder Treatment Prior Authorization Request Form, IHCP Initial Assessment Form for Substance Use Disorder (SUD) Treatment Admission, IHCP Reassessment Form for Continued Substance Use Disorder (SUD) Treatment, IHCP Applied Behavioral Analysis (ABA) Prior Authorization Checklist, IHCP Fast Track Notification Form [Healthy Indiana Plan], IHCP Full Eligibility Notification Form [Healthy Indiana Plan], Psychiatric Residential Treatment Facility (PRTF) Admission Assessment, Psychiatric Residential Treatment Facility (PRTF) Extension Request Tool, Indiana Health Coverage Programs Written Inquiry Form, Indiana Health Coverage Programs Administrative Review Request, Medicaid Third-Party Liability Accident/Injury Questionnaire, Medicaid Third-Party Liability Questionnaire. CareSource Medicaid members get access to a large provider network, A pregnant HIP member must promptly report her pregnancy. Traditional Medicaid is a program created to provide health care coverage to individuals who are not enrolled in managed care. Nonemergency medical transportation services for most members served through the fee-for-service delivery system are brokered through Southeastrans Inc. A Notification of Pregnancy transaction helps identify risk factors in the earliest stages of pregnancy and thereby improve birth outcomes. doctor, request an ID Card and more. Members with incomes above the poverty level, for example $13,590 a year for an individual, $18,310 for a couple or $27,750 for a family of four in 2022, that choose not to make their POWER account contributions will be removed from the program and not be allowed to re-enroll for six months. CareSource HIP and HHW plans provide extra benefits, services and rewards. HIP Plus provides best value coverage. POWER account contributions are a key part of the Healthy Indiana Plan. In the HIP program, in each calendar year the first $2,500 of a members medical expenses for covered benefits are paid with a special savings account called a Personal Wellness and Responsibility (POWER) account. With a regional headquarters located in Atlanta, CareSource is ready to welcome new Georgia members and health providers. In HIP Basic, members make a payment every time they receive a health care service, such as going to the doctor, filling a prescription or staying in the hospital. Family Member/Associate Transportation Providers. With HIP Plus, members do not pay every time they visit a doctor or fill a prescription. Unlike POWER account contributions, which belong to the member and could be returned if the member leaves the program early, copays cannot be returned to the member. Complete an IHCP Provider Enrollment Application. If you choose to leave the program early, your contributions not spent on health care costs may be returned to you. HIP Basic includes all the federally required essential health benefits, but does not provide coverage for vision, dental or chiropractic services, bariatric surgery or Temporomandibular Joint Disorders. When a member makes a POWER account payment, they become enrolled in HIP Plus, which offers better health coverage, including vision, dental and chiropractic benefits. These remaining funds can be used to lower POWER account contributions for the next year of coverage. The members portion is an affordable, monthly contribution based on income. Low-income individuals who don't qualify under another eligibility category may qualify for family planning services under the Family Planning Eligibility Program. Use the portal to pay your premium, check your deductible, change your doctor, request an ID Card and more. The IHCP will implement an electronic visit verification (EVV) system for federally required provider documentation of designated personal care and home health services. Hoosier Care Connect is a health care program for individuals who are aged 65 years and older, blind, or disabled and who are also not eligible for Medicare. Sign up for email and/or text notices of Medicaid and other FSSA news, reminders, and other important
Its because CareSource is more than just quality health care. Ordering, Prescribing or Referring Providers. For all pharmacy-related forms, refer to the Pharmacy Services page on this website. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. QUESTIONS ABOUT CARESOURCE? Qualified Provider Presumptive Eligibility (PE). If annual health care expenses are more than $2,500, the first $2,500 is covered by the member's POWER account, and expenses for additional health services over $2,500 are fully covered at no additional cost to the member (except in the HIP Basic program where the member is responsible for any required copayments). Meet CareSource PASSE Learn more about CareSource PASSE, a joint venture including CareSource and five Arkansas Medicaid providers of specialized health services. PACE provides community-based care for qualified members who are 55 and older that live in a PACE service area. Providers and their delegates can learn how to make the most of the IHCP Provider Healthcare Portal through web-based training sessions. Federal poverty levels are based on income and family size and contribution amounts for all family sizes can be calculated using this tool. Each health plan also has designated retail locations around the state where you can make your payment in person. Program Integrity Provider Education Training. Members do not have any cost sharing obligations. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. What happens if a HIP member becomes pregnant? CareSource; Humana Healthy Horizons Ohio; Medicare Savings Programs pay Medicare coinsurance, deductibles, and/or premiums for qualified elderly and disabled individuals. The changes have enhanced the individual and provider experience. It is important to answer their questions to maintain HIP State Plan benefits. Find presentations from the most recent IHCP workshops and seminars are archived here. CareSource is the number one plan of choice for Medicaid in Ohio. [] The Indiana Health Coverage Programs (IHCP) has a specific process for members, providers, or other interested parties who would like to submit requests for policy consideration. Members will receive information from their health plans about the various ways POWER account contributions can be paid. These HIP State Plan benefits will continue as long as your health condition, disorder or disability status continues to qualify you as medically frail. Click here to find monthly contribution amounts. The Indiana Health Coverage Programs (IHCP) will host the 2022 IHCPWorks seminar from Tuesday through Thursday, Oct.1113, 2022, at the Indianapolis Marriott East, located at 7202E.21stSt. in Indianapolis. Pregnant members will continue to not have any cost sharing responsibilities during this period. If you choose to leave the program early, your contributions not spent on health care costs will be returned to you. Ordering, Prescribing or Referring Providers. The companys managed care business model was founded in 1989 and today CareSource is one of the nations largest Medicaid managed care plans. Many sessions will allow time for questions following the presentation. information. When do HIP members select their health plan? For information about IHCP policies, procedures, and billing guidance (including information about electronic transactions), access these IHCP reference documents. FSSA sessions will include telehealth, managed long-term services and supports (mLTSS), electronic visit verification (EVV), the "Return to Normal" following the public health emergency, and much more. check your deductible, change your The IHCP Quick Reference Guide lists phone numbers and other information for vendors. check your deductible, change your The Right Choices Program monitors member utilization and, when appropriate, implements restrictions for members who would benefit from increased case coordination. A disability determination based on Social Security Administration criteria. Explore health and wellness information, newsletters, videos, frequently asked questions and more. If you are registering as a provider, select Practitioner and complete the information. Leading with Heart CareSource is nationally recognized for leading the industry in providing member-centric health care coverage. Hoosiers enrolled in Healthy Indiana Plan (HIP) and Hoosier Healthwise (HHW) can choose CareSource for health care coverage. There will be new individual and provider portals that will look and act differently. Call us at 1-844-607-2829 (TTY: 1-800-743-3333). HIP Basic is offered to members with income at or below the federal poverty level (FPL) who do not make their POWER Account payments. Each month, the members health plan will send a monthly statement showing how much is left in their POWER account. If you have questions about or changes in your health condition, please contact your health plan directly. The information that identifies and describes an enrolled IHCP provider is called a Provider Profile. Headquartered in Dayton, Ohio, the company has built a legacy of providing quality Indiana Family and Social Services Administration (FSSA) Benefits Portal. Total contributions may not exceed the members projected required annual contribution to their POWER account. The IHCP provider enrollment instructions and processes are outlinedon these web pages. Who is eligible for the Healthy Indiana Plan? Enroll as a provider with the IHCP to bring critical medical care to eligible Hoosier children and adults. The IHCP is working in collaboration with stakeholders to expand and improve SUD treatment. At the end of her pregnancy, additional pregnancy benefits will continue for another 12 month post-partum period. When registering your email, check the category on the drop-down list to receive notices of
HIP Basic does not cover vision, dental or chiropractic services and could be more expensive. Members who indicate that they are tobacco users during the plan selection period in the fall, may be subject to an increased contribution amount in the following year if they are still smoking. The Healthy Indiana Plan is a health-insurance program for qualified adults ages 19-64. HIP Plus members also get more visits to see physical, speech and occupational therapists than the HIP Basic program and extra services like weight loss surgery and jaw care (TMJ). As a nonprofit, CareSource is dedicated to clearing a path to health and well-being through innovative products, programs and services. HIP Plus allows members to make a monthly contribution to your POWER account based on income. These provider education training links cover topics such as documentation requirements, billing guidelines, and other program integrity- and audit-related issues. You can also double your reduction if you complete preventive services. Provider Relations regions are organized to minimize provider wait times when providers need assistance. It is important to answer their questions to maintain HIP State Plan benefits. The POWER account is used to pay for the first $2,500 in health care costs. The Postpartum Extension Demonstration waiver was developed from the passage of HB 1114 during Georgias 2020 legislative session. In HIP Plus, monthly POWER account payments are members only health care costs outside of any non-emergency visits to the emergency room. Join us and watch your business grow. Enrolling as a Managed Care Program Provider. Resources View the The only other cost you may have for health care in HIP Plus is a payment of $8 if you visit the emergency room when you dont have an emergency health condition. Choose CareSource when you apply for benefits or during an open enrollment period. Provider Services can also help with obtaining a unique CareSource portal ID for registration and log on. Members receive all key health benefits required by federal law, plus vision, dental and chiropractic services, plus extra services like weight loss surgery and jaw care. Current offerings are posted here. Not already Contracted to Sell for CareSource? The IHCP reimburses for long-term care services for members meeting level-of-care requirements. The only exception to this is a copayment for going to the emergency room for care when there is not a true emergency. Some members can have HIP Basic coverage even if they dont make their monthly payment, but in HIP Basic they will have to pay a fee every time they go to the doctor or fill a prescription. For information about IHCP policies, procedures, and billing guidance (including information about electronic transactions), access these IHCP reference documents. Session Information. The IHCP allows a family member or close associate of a Medicaid member to officially enroll as a driver, so the driver's mileage can be reimbursed. Pregnant members will have all cost sharing eliminated and will receive additional benefits during their pregnancy including non-emergency transportation. Find presentations from the most recent IHCP workshops and seminars are archived here. This manual communicates policies and programs and outlines key information such as claim submission and reimbursement processes, authorizations, member benefits and more to make it easier for you to do business with us. Its because CareSource is more than just quality health care. Navigate Rendering Provider List Use this spreadsheet to list all provider information for rendering providers. You may need to download Adobe Acrobat Reader to open these files. You can learn more about Amerigroup Community Care atwww.amerigroupcorp.com. The HIP Plus program provides comprehensive benefits including vision, dental and chiropractic services for a low, predictable monthly cost. These provider education training links cover topics such as documentation requirements, billing guidelines, and other program integrity- and audit-related issues. Hoosier Healthwise (HHW) is Indianas health care program for children and pregnant women.
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