Any license, certification or insurance that is required for a provider's enrollment in the Indiana Health Coverage Programs (IHCP) must be kept active and up to date. For certain kinds of licensure and certification, the IHCP can automatically verify that an expiring credential has been updated. In other cases, providers must recertify their enrollment by submitting documentation of the updated credential to the IHCP before the expiration date of the credential on file.
Note: "Recertification" of enrollment credentials is not the same as "revalidation" of enrollment. For more information about revalidation, see the Provider Enrollment Revalidation page on this website.
If a provider is required to recertify their enrollment credentials, a notification is sent to the provider 60 days before the end date of the provider's eligibility to participate. Providers must recertify their enrollment credentials even if they do not receive a notification. Providers should submit recertification applications 30 days prior to the expiration date of their current credentials.
For each provider type and specialty, the IHCP Provider Enrollment Type and Specialty Matrix indicates which, if any, of the enrollment credentials must be recertified with the IHCP as needed.
Note: Providers enrolled under the Ordering, Prescribing or Referring (OPR) classification are required to maintain their IHCP enrollment, but are not required to recertify. The IHCP verifies OPR licensing information periodically.
Basic Steps to Recertify
For credentials that require provider recertification (as indicated on the IHCP Provider Enrollment Type and Specialty Matrix), providers may use either of the following methods to submit the documentation before the expiration date of the credential on file:
- Recertify online using the IHCP Provider Healthcare Portal (IHCP Portal) – Log in to the provider account and use the Provider Maintenance > Provider Identification Changes options to enter the updated information and upload the required attachments. Providers are encouraged to use this quick and easy method to recertify their enrollment as needed.
- Recertify by mail – Complete the IHCP Provider Enrollment Recertification of Licenses and Certifications Form, print out the completed form, obtain required signatures, and send the form along with copies of the updated credentials to the address indicated on the form.
If a provider fails to recertify in a timely manner, the provider will be required to reenroll with the IHCP, either by completing a new application on the IHCP Portal or by submitting a new IHCP provider enrollment packet in its entirety. Providers that fail to recertify before their enrollment lapses will be issued a new IHCP Provider ID when they reenroll. When reenrolling, providers can request a retroactive effective date as early as the date that their enrollment was deactivated, as long as they have a claim for that date.
Processing a Recertification
Please allow at least 15 business days for processing before checking the status of a recertification. After the Provider Enrollment Unit processes the recertification, providers will be notified of the results as follows:
- If the submission needs correcting or is missing required documentation, the Provider Enrollment Unit will contact you by telephone, email or mail. This contact is intended to communicate what needs to be corrected, completed and submitted before the IHCP can process your enrollment transaction.
- If the update request is complete, it will be processed and you will receive notification.