Gainwell Technologies (formerly DXC Technology) has been contracted with the state of Indiana since 1991. Gainwell provides several services to the Indiana Health Coverage Programs (IHCP), including provider enrollment, customer service, eligibility verification systems, and fee-for-service prior authorization and claim processing.
Gainwell is responsible for the State’s Medicaid management information system, CoreMMIS. CoreMMIS contains current and historical member and provider information, including member eligibility and managed care assignment, provider enrollment and profile data, and claim activity. Enrolled providers can access relevant CoreMMIS information using secure accounts on the web-based IHCP Provider Healthcare Portal, which is also maintained by Gainwell.
As the State’s financial vendor (fiscal agent), Gainwell processes both paper and electronically submitted nonpharmacy claims for services rendered under the fee-for-service delivery system, such as through the traditional Medicaid program. Gainwell is responsible for ensuring accurate and timely payment to providers and processing provider claim disputes and appeals. Gainwell also collects member premiums for the M.E.D Works and Hoosier Healthwise Package C (Children's Health Insurance Program [CHIP]).
The Gainwell team provides both member and provider customer service, answering calls on eligibility, benefits, billing, provider enrollment, and premiums. In addition to their customer service representatives, the Gainwell field consultant team is also available to answer provider questions and offer provider training and education.
Gainwell is also responsible for several IHCP publications, including maintaining the provider website (in.gov/medicaid/providers) as well as this business partner website (in.gov/medicaid/partners).