The Indiana Health Coverage Programs (IHCP) encourages providers to use the IHCP Provider Healthcare Portal (IHCP Portal) to apply for enrollment in the IHCP. After enrolling, providers are asked to create an account on the IHCP Portal, from which they can maintain their enrollment profiles with up-to-date information. The IHCP Portal can also be used for enrollment transactions such as recertification, revalidation, adding a service location, reporting an ownership change, adding or removing rendering providers for a group, and disenrolling from the IHCP.
For providers that choose to submit their enrollment transactions by mail, rather than using the IHCP Portal, the IHCP offers provider enrollment applications (IHCP provider packets) and profile maintenance forms in PDF format. The appropriate form must be completed, printed, signed and sent by mail along with copies of all required supporting documents.
Whichever approach you choose – online using the IHCP Portal, or by mail using the appropriate PDF from this website – the table below will guide you to the information you need to get started with your IHCP provider enrollment transaction.
| To Do This... | Start Here... | Notes |
|---|---|---|
| Enroll with the IHCP to become an Indiana Medicaid provider | Complete an IHCP Provider Enrollment Application | To enroll as an IHCP provider, a complete application, along with all required documentation, must be submitted – either online, using the IHCP Provider Healthcare Portal (IHCP Portal) or by mail using the appropriate IHCP provider packet. |
| Family Member/Associate Transportation Providers | Special instructions exist for individuals enrolling to receive gas mileage reimbursement for transporting a family member or close associate to medical appointments. | |
| Ordering, Prescribing or Referring Providers | Special instructions exist for practitioners who wish to enroll solely to order, prescribe or refer services, drugs or medical supplies for IHCP members, rather than to perform services for IHCP reimbursement. | |
Enroll with a managed care entity (MCE) to be a participating provider for a managed care program | To serve Healthy Indiana Plan (HIP), Hoosier Care Connect, Hoosier Healthwise or Indiana PathWays for Aging (PathWays) members, providers must be enrolled with the member’s MCE. IHCP enrollment is required prior to applying for MCE enrollment. | |
Report changes to the information on file for your enrollment | Providers are required to report changes to contact information, name, address, disclosed entities, and other information in their provider profile within 10 business days. | |
Convert from an OPR-only provider to a rendering provider | To convert an enrollment from the OPR classification to the Rendering classification, complete and submit a rendering provider application (through the IHCP Portal or by mail), making sure to select “Conversion from OPR” as the enrollment request type. Following this process allows the start and end dates to be effective simultaneously, with no enrollment gap for the provider. | |
Recertify credentials with the IHCP | Recertify Provider Enrollment Licenses and Other Certifications | For certain licenses and certificates, providers are required to submit updated credentials as those on file approach expiration. The IHCP notifies providers when recertification is required. |
Revalidate an enrollment | Providers must revalidate their enrollment at regularly scheduled intervals. The IHCP notifies providers when it is time to revalidate their enrollment. The revalidation process must be completed through the IHCP Portal or by submitting the appropriate IHCP provider packet, completed in full with all required documentation. | |
Disenroll from the IHCP | Providers may voluntarily disenroll from the IHCP at any time. |
Advantages of Using the IHCP Portal for Provider Enrollment Transactions
Providers will find the online portal process much quicker and easier than submitting forms by mail. Online help guides users through the process from start to finish and provides immediate confirmation of enrollment transaction submissions.
The online enrollment process offers the following advantages over the process:
- Online transactions are more efficient and convenient.
- Business and personal information is more secure.
- Systematic checks verify that information is complete, reducing inadvertent submission errors and the need for corrections.
- Enrollment applications can be easily saved and edited as needed during the process.
- Supporting enrollment documentation can be uploaded electronically and submitted with the transaction.
- Providers can monitor the status of submitted transactions in real time.
Web-based training for using the IHCP Portal to enroll is available on the IHCP Provider Healthcare Portal Training page on this site. Assistance is also available from Provider Relations consultants.
Appeals Process for Involuntary Terminations and Denied Enrollments
If a provider's enrollment is involuntarily terminated or the IHCP denies a provider's enrollment or revalidation, the provider has the right to appeal the decision. See the Provider Enrollment provider reference module for details about the appeals process.
Additional Provider Enrollment Information
Additional information related to the IHCP provider enrollment process is available from this website:
- All providers enrolling in the IHCP must indicate the provider type and specialty (or specialties) and classification for their enrollment. See the Provider Classification, Type and Specialty page for more information.
- A National Provider Identifier (NPI) is required for almost all providers that want to enroll in the IHCP. Visit the National Provider Identifier page to learn more about the NPI.
- When enrolling as an IHCP provider, certain providers are subject to an application fee. The fee amount is set by the Centers for Medicare & Medicaid Services (CMS). Generally, the application fee applies to "institutional" providers, as defined by the CMS, and not to individual professionals, such as physicians. Visit the Provider Enrollment Application Fee page to learn more about which providers are subject to fee payment.
- Each provider is subject to a pre-enrollment risk assessment screening to determine the potential level of risk for fraud, waste and abuse. Providers are categorized by risk level – high, moderate or limited – using the CMS guidelines for risk determination. Visit the Provider Enrollment Risk Levels and Screening page to learn more about the risk levels and the related screening activities.
Providers are also encouraged to subscribe to email notifications for weekly alerts about new IHCP bulletins, updates to IHCP provider reference modules, and other important changes to the provider resources posted on this website. You may change your subscription at any time, and email addresses are never sold or used for any purpose other than IHCP business. We highly recommend subscribing to email notifications.