Business Transactions

Find information here about conducting business transactions with the Indiana Health Coverage Programs (IHCP), including member eligibility, billing, reimbursement, and recordkeeping.

• IHCP Provider Healthcare Portal
• Eligibility Verification
• Qualified Provider Presumptive Eligibility (PE)
  • Presumptive Eligibility for Inmates
  • Presumptive Eligibility Process FAQs
• Electronic Visit Verification
• Electronic Data Interchange (EDI) Solutions
  • IHCP Companion Guides
  • Trading Partner Registration Procedure
  • Software Testing Procedures
  • Common Compliance Errors Detected by the IHCP Translator
  • FAQs - EDI
• Billing and Remittance
  • Code Sets
  • IHCP Fee Schedules
  • Long-Term Care Per Diem Table
  • Diagnosis-Related Group Inpatient Reimbursement
  • Explanation of Benefits (EOB)
  • Best Practices for Claim Submission
  • Claim Administrative Review and Appeal
• Program Integrity
  • Protocol for Voluntary Self-Disclosure of Provider Overpayments​
  • Targeted Probe and Educate (TPE)
• Health Insurance Portability and Accountability Act (HIPAA)
  • Privacy and Security of Health Records
• Indiana Medicaid Promoting Interoperability Program
  • Registering for the Indiana Medicaid Promoting Interoperability Program
  • Attestation Documentation Requirements
  • Promoting Interoperability Audit Guidelines
  • FAQs - Indiana Medicaid Promoting Interoperability Program
  • Additional Program Resources