The Indiana Health Coverage Programs (IHCP) uses an information management system called CoreMMIS, which stands for Core Medicaid Management Information System. 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.
Providers interface with CoreMMIS through the online IHCP Provider Healthcare Portal (Portal). The Portal is an internet-based solution that offers enhanced reliability, speed, ease of use, and security to providers and other partners doing business with the IHCP.
In the Portal, providers can perform the following transactions:
- Submit fee-for-service (FFS) claims and claim adjustments
- View FFS claim status and claim history
- View FFS Remittance Advices and payment information
- Request prior authorization (PA) and view PA status
- Verify member eligibility and view member information
- Request and view Right Choices Program (RCP) assignments
- Submit and view Notifications of Pregnancy (NOPs) (certain provider types only)
- Submit presumptive eligibility applications (qualified providers only)
- Maintain Provider Profiles
- Submit provider enrollment applications and other related transactions
- Submit secure correspondence
Establishing a Secure Portal Account
Authorized representatives and delegates can access the IHCP Portal to register a secure account or log into an existing account.
To conduct business with the IHCP, providers need 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. The same person can serve as the Provider account representative on different Provider accounts for providers that have multiple IHCP service locations. The provider representative has full access to all information related to the service location and assigns and manages any delegates with Portal access for a service location. A delegate is anyone designated to work in the provider's Portal account for a specific 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. The provider's representative must authorize all delegates and assign delegate permissions in the Portal before delegates can register on the Portal. The system will generate a Delegate Code unique to each authorized delegate. The provider's representative must provide all delegates with their unique Delegate Code and instruct them to register a Delegate account in the Portal.
Note: The Portal can be accessed by anyone with a current Delegate account. It is the responsibility of the provider representative to add and remove (deactivate) delegate access, as appropriate, when staff changes occur.
The IHCP Provider Healthcare 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 Help Desk by calling 1-800-457-4584 and selecting the appropriate option.
The Portal itself includes online help functions to assist users. In addition, more information about the Portal is available as follows:
- Take the online web-based trainings on the Portal available on the Provider Healthcare Portal Training web page.
- See the Provider Healthcare Portal provider reference module on the Provider Reference Materials page.
- Refer to IHCP provider bulletins - search for the keyword "portal."
- Contact Customer Assistance at 1-800-457-4584.
- Contact the IHCP Provider Relations field consultant in your area.