- Medical and dental claims processing inappropriately
HP has identified an issue with the claims processing system. This issue affects claims processed December 24, 25, and 26, 2014. Claims may have been inappropriately paid or denied. HP is reprocessing and mass adjusting all claims associated with this issue as of today. Providers will begin seeing reprocessed and adjusted claims on Remittance Advices (RAs) as of Tuesday, January 6, 2015.
- IHCP Makes Changes to Hoosier Healthwise Member Cards
The Indiana Health Coverage Programs (IHCP) is changing how member cards for individuals enrolled in Hoosier Healthwise are issued. Each managed care entity (MCE) will assume responsibility for issuing Hoosier Healthwise member ID cards for newly eligible Hoosier Healthwise members enrolled under their health plan. This change will be implemented in phases and may result in some minor differences in the look of Hoosier Healthwise member cards printed after January 1, 2015.
- ACA increase in reimbursement for primary care services ending December 31, 2014
The Affordable Care Act (ACA) required a temporary increase in Medicaid payments for qualifying primary care services provided by qualifying physicians for dates of service (DOS) in calendar years (CYs) 2013 and 2014. The federally funded, temporary rate increase was authorized only for these two calendar years. This temporary increase will end December 31, 2014, and the Medicaid rate structure will return to its preexisting levels for DOS on or after January 1, 2015.
- Update your IHCP provider information for 2014 taxes!
In preparation for generating and mailing tax filing documents, the Indiana Health Coverage Programs (IHCP) must receive any updates to “mail to,” “pay to,” or “home office” addresses, or to your 2014 taxpayer identification information, by December 14, 2014.
- Claims processing problem fixed
The Indiana Health Coverage Programs (IHCP) has fixed the system issue identified in the News and Announcements article posted on October 24, 2014. The issue caused some claims to pay or deny in error with certain National Correct Coding Initiative (NCCI)-related explanation of benefits (EOB) codes.
- RAs to be available on Web interChange for additional weeks
Beginning November 1, 2014, Indiana Health Coverage Programs (IHCP) Remittance Advices (RAs) will be available for additional weeks on Web interChange. Currently, the most recent four weeks of RAs are visible to providers. Each week beginning November 1, providers will see additional weeks of RAs display, up to a total of 12 weeks.
- Claims denied in error for EOB codes 4183 and 9999
The Indiana Health Coverage Programs (IHCP) has discovered a system issue causing some claims to deny incorrectly with EOB codes 4183 and 9999. HP is diligently working to correct this issue.
- CMS issues Final Rule for Home and Community-Based Services (HCBS)
The Centers for Medicare & Medicaid Services (CMS) issued regulations effective March 17, 2014, that define the settings in which it is permissible for states to pay for Medicaid HCBS. The Statewide Transition Plan outlining Indiana’s plan for coming into full compliance with the regulations will be open for public comment November 1 – December 1, 2014.
- Indiana Core MMIS under development
The Indiana Health Coverage Programs (IHCP) is in the design phase of developing an enhanced Medicaid Management Information System (MMIS) to replace its current IndianaAIM system. The new system will include state-of-the-art technology intended to make doing business with the IHCP easier and more efficient.
- How the ICD-10 delay affects the IHCP
For questions and answers about the ICD-10 delay, see BR201437, and watch for more information about ICD-10 on this site in coming months.
- Hospital Presumptive Eligibility QP Webinar
Acute care hospitals are encouraged to have representatives participate in “Hospital Presumptive Eligibility Qualified Provider Training,” an online webinar scheduled for September 18, 2014, 10 – 11:30 a.m. Although this webinar will not be the only HPE training session offered, it is the next available opportunity to receive the training necessary to become a QP.
- Anthem assumes responsibility for HIP ESP claims processing
Effective July 1, 2014, Anthem Insurance Companies, Inc. will assume responsibility for processing outstanding claims for members who continued participation in the Healthy Indiana Plan (HIP) Enhanced Services Plan (ESP) program administered by Xerox through April 30, 2014. Anthem will follow existing policies and procedures for processing ESP claims.
- Public Hearings on HIP 2.0 Scheduled for May 28 and May 29
The Family and Social Services Administration (FSSA) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to expand the accessibility of the existing HIP program to eligible Indiana residents. Public hearings about this new initiative, referred to as HIP 2.0, are scheduled for May 28 and May 29, 2014.
- ACA Duplicate Payment Recoupment Update
The Indiana Health Coverage Programs (IHCP) notified providers via IHCP banner page BR201410, dated March 11, 2014, that a duplicate payment for the fourth-quarter 2013 Affordable Care Act (ACA) primary care physician fee payments to fee-for-service providers had occurred. Further, it informed providers they would receive a notification letter with additional information regarding the recoupment of the overpayments, which would begin on March 28, 2014.
- Providers May Experience Delays in Claims Processing
The Indiana Health Coverage Programs (IHCP) is experiencing some delay in processing fee-for-service claims submitted on and after April 1, 2014. Normal claims processing is underway; however, due to a backlog of claims, providers may experience delays in the typical claims processing and payment time frames, as well as delays in the ability to view submitted claims using Web interChange Claim Inquiry.
- Attention, long-term care facilities!
On the Remittance Advices dated April 1, 2014, a retroactive rate adjustment caused accounts receivables (ARs) to be set up in error. This issue has been identified and is being corrected by HP. Although some providers were advised to resubmit the affected claims, it has been determined these claims should NOT be resubmitted. Paid claims are being reprocessed by HP.
- Date changed to May 1 for submission of EP meaningful use attestations
The date Indiana will begin accepting Program Year 2014 meaningful use (MU) attestations for eligible professionals (EPs) is May 1, 2014, rather than April 17, 2014, as originally announced.
- Eligibility Verification via OMNI 380 Terminals Unavailable
Effective at midnight Friday, March 14, 2014, the Omni 380 Terminals will be unavailable for users while brought down for unscheduled maintenance. During this time, Indiana Health Coverage Programs (IHCP) member eligibility can be verified using one of the other available free options, as specified in Chapter 3 of the IHCP Provider Manual.
- Effective April 1, 2014, the IHCP will accept only the revised version of the CMS-1500
Effective April 1, 2014, the Indiana Health Coverage Programs (IHCP) will accept only the revised version of the CMS-1500 (02/12) paper claim form. Paper claims submitted on the current version of the CMS-1500 (08/05) after March 31, 2014, will not be processed and will be returned to the provider.
- Duplicate ACA primary care physician fee payments issued for fourth quarter 2013
On February 18, 2014, Indiana Health Coverage Programs (IHCP) issued the fourth-quarter 2013 Affordable Care Act (ACA) primary care physician fee payments to fee-for-service providers. On February 25, 2014, these payments were reissued in error, resulting in duplicate payments. The IHCP will begin recouping the overpayments on March 28, 2014. All affected providers will receive a notification letter with information regarding the recoupment of the overpayments.
- The IHCP is testing ICD-10!
The Indiana Health Coverage Programs (IHCP) is testing ICD-10, including testing the new APR-DRG, now through July 31, 2014.
- Eligible Professionals May Attest to Meaningful Use for EHR Program Year 2014 Beginning April 17, 2014
Indiana will begin accepting Program Year 2014 meaningful use (MU) attestations for Eligible Professionals (EPs) April 17, 2014. Please do not submit your attestation until April 17, 2014, or after.
- UB-04 and revised CMS-1500 Claim Forms with missing or invalid ICD indicators will be returned to providers!
Effective January 6, 2014, ICD indicators are required on all UB-04 and revised CMS-1500 claim forms. Revised CMS-1500 and UB-04 claim forms with missing or invalid ICD indicators will be returned to providers.
- Deadline for CMS ICD-10 Provider Readiness Assessment extended to February 10, 2014
The closing date of the Centers for Medicare & Medicaid Services’ (CMS’) national ICD-10 Provider Readiness Assessment has been extended to February 10, 2014. We would greatly appreciate your taking the time before February 10 to respond.
- Waiver and transportation claims to be reprocessed and mass adjusted
The Indiana Health Coverage Programs (IHCP) has identified that waiver and transportation claims billed with modifiers U3, U7, or HW submitted on January 29, 2014, with dates of service on or after July 1, 2013, were erroneously subjected to audits 9110-9120 and 9122 and denied.
- 2014 Medicaid Disability Eligibility and Spend Down Changes
Effective June 1, 2014, Indiana is changing the way Hoosiers will obtain Medicaid coverage in the aged, blind or disabled categories. Indiana will automatically enroll individuals that the Social Security Administration determines eligible for Supplemental Security Income into Indiana Medicaid and will accept all SSA determinations of disability.
- SDGs and LTC audit protocol training scheduled for April 11, 2014
The Indiana Health Coverage Programs (IHCP) is offering a series of virtual training sessions focusing on the Supportive Documentation Guidelines (SDGs) and LTC audit protocols.