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Provider Addresses Used by the IHCP

The Indiana Health Coverage Programs (IHCP) maintains four unique addresses for each enrolled billing or group provider:

  • Service location address
  • W-9 address
  • Mail-to address
  • Pay-to address

With this flexibility, a provider may specify a different, or the same, address for different business situations.

Because four different address options exist, providers may be confused about what type of IHCP mail goes to which address. The following table will help alleviate confusion with regard to IHCP mailing addresses.

Provider Addresses Used by the IHCP

Address Type

Description

Service Location

Typically, this is the address of the physical site where services are rendered and records are kept. Providers that render services exclusively as telehealth or at a “place-of-service site” (such as members’ homes) use their home or business office as their service location address.

Note: This address must be a physical location; a post office box or UPS store cannot be used for this address.

W-9

Provider address as recognized by the Internal Revenue Service (IRS) – which, for most providers, is the owner/home office address. Must match the address entered on the provider’s W-9 form.

The IHCP uses this address for the following correspondence:

  • 1099 forms
  • IRS information
Mail To

Address to which the IHCP mails the following items:

  • Provider update and enrollment confirmation letters
  • Recertification Notice
  • Revalidation Notice
  • PMP disenrollment letters
  • Special correspondence
Pay To

Address to which IHCP sends the following items:

  • Payment checks (if the provider is not set up for electronic funds transfer [EFT])
  • General claim payment information

Note that the IHCP uses the group's address if the communication relates to a rendering practitioner who is linked to a group; the IHCP uses the individual practitioner's address if the communication relates to a practitioner who is a sole proprietor.

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