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Anthem assumes responsibility for HIP ESP claims processing

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Anthem assumes responsibility for HIP ESP claims processing

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:

ESP Claims
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.