Indiana Health Coverage Programs (IHCP) provider enrollment packets for the IHCP Provider Enrollment Packet Finder:
- IHCP Correctional Facility Clinic Provider Enrollment and Provide Maintenance Packet
- IHCP Billing Provider Enrollment and Profile Maintenance Packet
- IHCP Durable Medical Equipment Provider Enrollment and Profile Maintenance Packet
- IHCP Group and Clinic Provider Enrollment and Profile Maintenance Packet
- IHCP Family Member or Associate Transportation Provider Enrollment and Profile Maintenance Packet
- IHCP Hospital and Facility Provider Enrollment and Profile Maintenance Packet
- IHCP School Corporation Provider Enrollment and Profile Maintenance Packet
- IHCP Medicare-Only Provider Enrollment and Profile Maintenance Packet
- IHCP Ordering, Prescribing or Referring Provider Enrollment and Profile Maintenance Packet
- IHCP Pharmacy Provider Enrollment and Profile Maintenance Packet
- IHCP Radiology Provider Enrollment and Profile Maintenance Packet
- IHCP Rendering Provider Enrollment and Profile Maintenance Packet
- IHCP Transportation Provider Enrollment and Profile Maintenance Packet
- IHCP Waiver Billing Provider Enrollment and Profile Maintenance Packet
- IHCP Waiver Group Provider Enrollment and Profile Maintenance Packet
- IHCP Waiver Rendering Provider Enrollment and Profile Maintenance Packet
For specialty-specific enrollment requirements related to supporting documentation, application fee and risk-assignment, see:
- IHCP Provider Enrollment Type and Specialty Matrix
- IHCP Provider Enrollment Risk Category and Application Fee Matrix.
Additional Information for Transportation Providers
- State law requires transportation providers with specialty 263, 264, 265, 267 or 269 to purchase a surety bond to be eligible to enroll. This requirement applies to providers that are newly enrolling, reporting a change of ownership or reporting a purchase or transfer of assets. Indiana Code (IC) exempts certain providers from this requirement, including 501(c)(3) nonprofit organizations, providers that are owned or controlled by a hospital or pharmacy licensed in Indiana, as well as other providers as specified in IC 12-15-11-2.5(b). A surety bond that meets state of Indiana requirements can be obtained by contacting a licensed insurance broker and providing the broker with a copy of the Indiana Medicaid Surety Bond Requirements.
- After you are enrolled as an IHCP provider, you must contract with one or more of the transportation brokers that manage transportation service for members. Refer to the links below:
- Nonemergency transportation for Traditional Medicaid members – contact Verida.
- All transportation services for Healthy Indiana Plan (HIP) and Hoosier Healthwise members contact:
- All transportation services for Hoosier Care Connect members contact:
- All transportation services for Indiana PathWays for Aging members contact:
Additional Information for Waiver Providers
Before submitting an IHCP enrollment application, waiver providers must have Indiana Family and Social Services Administration (FSSA) certification. The provider must be certified for the corresponding service by the appropriate agency: the Office of Medicaid Policy and Planning (OMPP) for Traumatic Brain Injury (TBI), Health and Wellness (H&W), or Indiana PathWays for Aging (PathWays) waiver services, or the Bureau of Disabilities Services (BDS) for Family Supports Waiver (FSW) or Community Integration and Habilitation (CIH) waiver services. For OMPP certification, providers must submit the request through the OMPP HCBS Certification Portal. For BDS certification, providers must submit the request to BDSProviderServices@fssa.in.gov. Waiver specialties are assigned during the certification process. For more information, see the following provider reference modules, available on this website: