The Indiana Health Coverage Programs (IHCP) uses the online IHCP Provider Healthcare Portal (Portal) as an interface between providers and the Core Medicaid Management Information System (CoreMMIS). CoreMMIS allows the IHCP to perform program management functions, including to accurately and efficiently adjudicate claims in alignment with IHCP coverage policies and national billing guidelines. The Portal is an interactive, secure, and easy-to-use tool for providers and other partners to exchange information with the IHCP through the internet.
Providers that wish to enroll in the IHCP can use the Portal to submit an application. After the application is approved, the enrolled provider can then establish a secure Portal account through which the following transactions can be performed:
- Verify member eligibility and view details about the member's coverage
- Request prior authorization (PA) and view PA status for nonpharmacy services covered under the fee-for-service (FFS) delivery system
- Submit FFS, nonpharmacy claims and claim adjustments; view claim status and history
- View Remittance Advice (RA) and payment information for FFS, nonpharmacy claims
- Submit provider referrals to be added to a Right Choices Program (RCP) member's lock-in list (RCP primary medical providers [PMPs] only)
- Submit and view Notifications of Pregnancy (NOPs) for managed care members (certain provider types only)
- Submit presumptive eligibility applications (qualified providers only)
- Update information in the provider profiles
- Submit secure correspondence (claim-related correspondence limited to FFS, nonpharmcy only)
Establishing a Secure Portal Account
Authorized representatives and delegates can access the IHCP Provider Healthcare Portal to register a secure account or log in to an existing account.
Providers are required to create a unique, secure Provider account on the Portal for each IHCP-enrolled service location. Providers must designate a representative to register the Provider account in the Portal. One person can serve as the representative on multiple Provider accounts for providers that have more than one service location.
The provider representative has full access to all information and Portal functions related to the service location and can assign and manage delegates with varying degrees of Portal access for a service location. The role of representative should not be assigned to trading partners or contractors. All provider staff should be made aware of the designated representative for security purposes.
After the provider representative has been selected, he or she must register the Provider account for the service location. Each service location is limited to one Provider account.
A delegate is anyone other than the Provider account representative who is designated to work in the provider's Portal account for a specific service location. Before they can register an account, all delegates must be authorized and assigned delegate permissions in the Portal, either by an account representative or by a previously authorized delegate with permissions to add additional delegates. When a new delegate is authorized for a Portal account, the system generates a unique Delegate Code, which must be provided to the delegate along with instructions to register a Delegate account in the Portal.
The Portal can be accessed by anyone with a current Delegate account. It is the responsibility of the provider representative to ensure that delegate access is added and removed (deactivated), as appropriate, when staff changes occur.
The Portal is compliant with Health Insurance Portability and Accountability Act (HIPAA) requirements for direct data entry (DDE). Encryption and secured socket layer (SSL) connections protect the data in transit. HIPAA security regulations require that passwords are not shared; therefore, each user of the Portal must have a unique user ID. For security purposes, Portal passwords must be reset every 60 days. Password resets and other Portal account maintenance can be performed online.
Technical questions about registering or maintaining Portal accounts should be referred to the Electronic Solutions technical assistance line by calling 1-800-457-4584 (press option 3 twice to reach a Portal representative).
The Portal itself includes online help functions to assist users. In addition, more information about the Portal is available as follows:
- Consult the Portal FAQs for information about registering and managing accounts on the Portal.
- Take the web-based trainings and review the quick reference guides on the Provider Healthcare Portal Training page to learn about various aspects of the Portal.
- See the Provider Healthcare Portal provider reference module.
- Refer to IHCP provider bulletins and banner pages – search for the keyword "portal."
- Contact the IHCP Provider Relations field consultant in your area.