Anthem assumes responsibility for HIP ESP claims
The Healthy Indiana Plan (HIP) Enhanced Services Plan (ESP)
program was discontinued as of December 31, 2013. At that time,
members with continued eligibility transitioned to a HIP managed
care entity (MCE) or continued ESP participation under Xerox
through April 30, 2014.
Effective July 1, 2014, Anthem Insurance Companies, Inc. will
assume responsibility for processing outstanding claims for members
who continued participation in the HIP ESP program administered by
Xerox. Anthem will follow existing policies and procedures for
processing ESP claims. The time limit for filing claims is 365 days
from the date of service, and all providers contracted with the
Indiana Health Coverage Programs (IHCP) are considered in network.
Services will be paid at the appropriate Medicare rates, or 130% of
the Medicaid rates, as instructed by the HIP Reimbursement
Manual at indianamedicaid.com.
ESP claims should continue to be filed on paper and
submitted to the same mailing address:
P.O. Box 33077
Indianapolis, IN 46203-0077
In addition to processing claims, beginning July 1, 2014, Anthem
will also handle disputes and appeals related to ESP claims,
including disputes and appeals related to claims previously
processed by Xerox. The IHCP reminds providers that claim disputes
must be received within 60 calendar days of the date of the
explanation of benefits (EOB) or Remittance Advice. Appeals must be
received within 33 calendar days of a dispute decision.
Anthem has assigned an ESP run-out specialist to oversee related
processes and assist providers. Providers should direct questions
to Anthem toll-free at 1-844-784-8417 or via email at ESPRUN-Out@Anthem.com.