Effective April 1, 2014, the IHCP will accept only the revised version of the CMS-1500

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. The effective date for transition to the new form is based on date of claim submission rather than date of service. For more information and instructions about filling out the revised CMS-1500, see IHCP Bulletin BT201353.

In addition, ICD indicators are required on all UB-04 and revised CMS-1500 claim forms. UB-04 and revised CMS-1500 claim forms with missing or invalid ICD indicators will be returned to providers. For more information, see IHCP Bulletins BT201352 and BT201353. If you have questions, please contact Customer Assistance toll-free at 1-800-577-1278.