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IHCP Companion Guides

This page contains Indiana Health Coverage Programs (IHCP) Companion Guides for Health Insurance Portability and Accountability Act (HIPAA) version 5010 electronic transactions. The guides contain structure and specifications for transactions exchanged directly with Gainwell Technologies (fiscal agent for the IHCP). Providers and vendors developing software for electronic data interchange (EDI) may need to view multiple guides.

The IHCP Companion Guides are updated as needed. See the Change Summary section within each guide for a history of updates. When a system modification is forthcoming, significant changes are described in advance in the Upcoming Changes for IHCP Companion Guides section of this page.

The IHCP Companion Guides are intended only to supplement the adopted National Electronic Data Interchange Transaction Set Implementation Guides (commonly called Implementation Guides), which are available for purchase and download through the Washington Publishing Company website. The IHCP Companion Guides are never intended to modify, contradict, or reinterpret the rules established by the Implementation Guides.

IHCP Companion Guides

NameDate Updated
IHCP Connectivity Guide V3.4August 2019
TA1 and 999 Acknowledgements V1.4March 2021
270/271 Health Care Eligibility Benefit Inquiry and Response Transactions V3.6May 2021
276/277 Health Care Claim Status Request and Response Transactions V3.3July 2019
277U Health Care Payer Unsolicited Claim Status Response V3.2January 2019
278 Prior Authorization Request and Response V3.0August 2017
820 MCE Capitation Payment Information Transaction V3.6July 2020
834 MCE Benefit Enrollment and Maintenance Transaction V5.5June 2021
835 Health Care Claim Payment/Advice Transaction V3.2July 2018
837D Health Care Claim: Dental Transaction V3.9March 2021
837I Health Care Claim: Institutional Transaction V3.7March 2021
837P Health Care Claim: Professional Transaction V3.7March 2021

Note: The IHCP Companion Guide for electronic pharmacy claim transactions, National Council for Prescription Drug Programs (NCPDP) D.0 Transaction Payer Sheet, is available from the Optum Rx Indiana Medicaid website.

Upcoming Changes for IHCP Companion Guides

When system modifications are planned, advance notification is given to allow vendors time to make appropriate changes to their software and perform testing, if needed. The following documents describe upcoming changes to applicable IHCP Companion Guides. Please review these documents and make necessary modifications to your system before the implementation date.

NameDate Updated
No upcoming changes at this time

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