How you know. These payments may range from $4 to $8 per doctor visit or prescription filled and may be as high as $75 per hospital stay. The information that identifies and describes an enrolled IHCP provider is called a Provider Profile. Providers; Provider Overview. input, Family and Social Services Administration, Transferring to or from Other Health Coverage, Click here to find monthly contribution amounts, Click here for a comparison of the available health plans, Click here to see a list of conditions that may qualify you as medically frail, Report Unlike POWER account contributions, which belong to the member and could be returned if the member leaves the program early, copays cannot be returned to the member. Members who leave HIP and return in the same calendar year will still have their same POWER account and health plan. The IHCP Provider Healthcare Portal is an internet-based solution that offers enhanced reliability, speed, ease of use, and security to providers and other partners doing business with the IHCP. This manual communicates policies and programs and outlines key information such as claim submission and reimbursement processes, authorizations, member benefits and more to make it easier for you to do business with us. Members receive monthly statements that show how much money is remaining in the POWER account. If you have questions about or changes in your health condition, please contact your health plan directly. Members are limited to 30-day prescription supply and cannot order medications by mail. PACE provides community-based care for qualified members who are 55 and older that live in a PACE service area. HIP Basic members pay copays for most health services like doctor visits, prescriptions and hospital stays. All changes will be effective January 1 and stay in effect for the next calendar year. Amerigroup is dedicated to offering Georgia Medicaid families and PeachCare for Kidsmembers the standard Medicaid benefits plus extra value-added services. Current offerings are posted here. HIP Basic members will be given the opportunity to re-enroll in HIP Plus at the end of their annual cycle, or plan year, defined by their enrollment date. Complete an IHCP Provider Enrollment Application. Free or low cost health insurance for eligible low-income adults, families, children, pregnant women, elderly adults and people with disabilities. Members will have 60 days to make their POWER account contribution from the start of the HIP Basic benefits. The HIP State Plan benefits grant you comprehensive coverage including vision, dental, non-emergency transportation, chiropractic services and Medicaid Rehabilitation Option services. On or before January 1, 2020, some Indiana Medicaid providers will begin to use a system called Electronic Visit Verification. Providers can get help by calling Provider Services at 1-800-488-0134. Why is it important to make POWER account contributions? Members who manage their health and POWER accounts wisely could still have money in their accounts after a year of coverage. Find links to provider code sets, fee schedules and more. HIP Basic is offered to members with income at or below the federal poverty level (FPL) who do not make their POWER Account payments. If you are just joining HIP and want to make sure you choose a health plan that includes your doctor, call 877-GET-HIP-9 to discuss your options. Providers must be enrolled as MRT providers to be reimbursed for MRT services. Rooms at the discounted rate are booked on a first-come, first-serve basis. Traditional Medicaid is a program created to provide health care coverage to individuals who are not enrolled in managed care. With HIP Plus, members can get 90-day refills on prescriptions and receive medication by mail order. Backed by our parent company, Centene Corporation, Peach State draws on financial stability and national expertise to deliver local services and programs. When do HIP members select their health plan? Amerigroup will provide effective programs and services to patients, coordinate quality healthcare and assist with important case management and preventive care services. Fax: 1-888-752-0012. The members portion is an affordable, monthly contribution based on income. The Healthy Indiana Plan empowers members to make important decisions about the cost and quality of their health care. Prior authorization is required for certain covered services to document the medical necessity for those services before services are rendered. Each child or youth ages 16 months through 17 years can earn up to $195 by completing healthy activities. HIP Basic members also receive an opportunity to move to HIP Plus if they earned rollover in the prior calendar year. Providers can find pharmacy benefit information for the program/health plan with which the member is enrolled. HIP Plus members also get more visits to see physical, speech and occupational therapists than the HIP Basic program and extra services like weight loss surgery and jaw care (TMJ). Can I keep my doctor? Prior authorization is required for certain covered services to document the medical necessity for those services before services are rendered. Press Enter or Space to expand a menu item, and Tab to navigate through the items. In partnership with Georgia Families,Peach State will help educate both the Georgia Medicaid members and healthcare providers about the enhancements to the Medicaid and PeachCare for Kids programs. The essential health benefits are covered but not vision, dental or chiropractic services. The IHCP Quick Reference Guide lists phone numbers and other information for vendors. Note: Many of these forms have been integrated into the IHCP Provider Healthcare Portal (Portal) and, therefore, are not required for transactions conducted via the Portal. If you choose to leave the program early, your contributions not spent on health care costs may be returned to you. When registering your email, check the category on the drop-down list to receive notices of The IHCP offers provider training opportunities including instructor-led workshops, seminars, webinars, and self-directed web-based training modules. There is a reason more Ohioans choose CareSource for their Medicaid plan than all other plans combined. The Workshop Registration Tool enables providers to sign up for workshops. IHCP Medicaid Rehabilitation Option services include community-based mental health care for individuals with serious mental illness, youth with serious emotional disturbance, and/or individuals with substance use disorders. Hoosier Care Connect is a health care program for individuals who are aged 65 years and older, blind, or disabled and who are also not eligible for Medicare. The IHCP will implement an electronic visit verification (EVV) system for federally required provider documentation of designated personal care and home health services. These provider education training links cover topics such as documentation requirements, billing guidelines, and other program integrity- and audit-related issues. Members normally served in Traditional Medicaid include individuals eligible for both Medicare and Medicaid, individuals who Home- and Community-Based Services (HCBS). Press Enter again after expanding an item to navigate to that page. Join us and watch your business grow. Maintaining Your IHCP Provider Enrollment. The 2022 IHCPWorks seminar will include educational sessions presented by all IHCP partners, including the Indiana Family and Social Services Administration (FSSA), Gainwell Technologies, Anthem, Managed Health Services (MHS), MDwise, CareSource, and UnitedHealthcare. Fast Track allows members to make a $10 payment while their application is being processed. The IHCP reimburses for hospice services in a hospice facility, in a nursing facility, and in a private home. The Preferred Diabetes Supply List helps ensure that IHCP members receive the highest quality products at the lowest cost. These payments may range from $4 to $8 per doctor visit or prescription filled and may be as high as $75 per hospital stay. Managed Health Services. PACE provides community-based care for qualified members who are 55 and older that live in a PACE service area. For information about IHCP policies, procedures, and billing guidance (including information about electronic transactions), access these IHCP reference documents. Press Escape to collapse the expanded menu item. HIP Basic requires members to make a small payment, called a copayment, each time they go to the doctor or hospital except for preventive care or family planning services. The IHCP will implement an electronic visit verification (EVV) system for federally required provider documentation of designated personal care and home health services. The $10 payment goes toward the members first POWER account contribution. Low-income individuals who don't qualify under another eligibility category may qualify for family planning services under the Family Planning Eligibility Program. If your annual health care expenses are more than $2,500, the first $2,500 is covered by your POWER account, and expenses for additional health services are fully covered at no additional cost to you. For details on all HHW plans please visit our Hoosier Healthwise Plan page. Complete an IHCP Provider Enrollment Application. Providers can order CMS-1500 (professional), ADA 2012 (dental) and UB-04 (institutional) claim forms from a standard form supply company. The IHCP provider enrollment instructions and processes are outlinedon these web pages. Explore health and wellness information, newsletters, videos, frequently asked questions and more. You may need to download Adobe Acrobat Reader to open these files. The Workshop Registration Tool enables providers to sign up for workshops. Changing the slide by swiping, clicking a dot, or using the arrow keys will automatically pause auto-rotation. There is a small monthly premium payment and co-pay for some services based on family income. Walk-in registrations will be allowed; however, it is not recommended, as space is limited. Find clinical tools and information about working with CareSource. Local, state, and federal government websites often end in .gov. doctor, request an ID Card and more. Free rides to health care visits or to pick up food at food pantries or other food distribution sites. During registration, you must first register for the seminar. Provider Services can also help with obtaining a unique CareSource portal ID for registration and log on. Members can also call 877-GET-HIP-9 and ask. The Indiana Health Coverage Programs (IHCP) will host the 2022 IHCPWorks seminar from Tuesday through Thursday, Oct.1113, 2022, at the Indianapolis Marriott East, located at 7202E.21stSt. in Indianapolis. It can also be used to review or modify a registration. Each month, the members health plan will send a monthly statement showing how much is left in their POWER account. For more information about the full seminar lineup, see the 2022IHCPWorks Session Descriptions and Schedule. Fast Track is a payment option that allows eligible Hoosiers to expedite the start of their coverage in the HIP Plus program. Hoosier Healthwise Standard Plan is a full-service plan for children up to age 19 and pregnant women with low income. WERE HERE TO HELP! Medicaid; Benefits & Services; Rewards; Pharmacy; Plan Documents; Marketplace. HIP Basic includes all the federally required essential health benefits, but does not provide coverage for vision, dental or chiropractic services, bariatric surgery or Temporomandibular Joint Disorders. Providers and their delegates can learn how to make the most of the IHCP Provider Healthcare Portal through web-based training sessions. CMOs are Care Management Organizations. As a nonprofit, CareSource is dedicated to clearing a path to health and well-being through innovative products, programs and services. CareSource is one of the nations largest Medicaid managed care plans, CareSource has been providing life-changing health care coverage to people and communities for nearly 30 years.As a nonprofit, CareSource is dedicated to clearing a path to health and well-being through innovative products, programs and services. The IHCP reimburses for hospice services in a hospice facility, in a nursing facility, and in a private home. Preadmission Screening and Resident Review (PASRR). At CareSource, we understand there is more to health and well-being than just great health care. Our provider manual is a resource for working with our health plan. Topics will include prior authorization, provider enrollment, and professional (CMS1500) and institutional (UB04) claims, among others. For information about IHCP policies, procedures, and billing guidance (including information about electronic transactions), access these IHCP reference documents. It is important to answer their questions to maintain HIP State Plan benefits. Where and how can you pay your POWER account contribution? Children who are wards of the State, receiving adoption assistance, foster children and former Hoosier Healthwise is a health care program for children up to age 19 and pregnant women. There will be new individual and provider portals that will look and act differently. Get Contracted by following the link below. information. Find important information for providers, software developers, and trading partners that communicate via electronic data interchange format and direct data entry. Qualified Provider Presumptive Eligibility (PE). Accessibility Choose CareSource when you apply for benefits or during an open enrollment period. Reservations at the Marriott may be made online (preferred) at the seminar welcome page, or by telephone at 8009913346 referencing the group name "Indiana Medicaid Conference." Enrolling as a Managed Care Program Provider. P4HB fills a critical gap in health care for underinsured and uninsured women by expanding Medicaid eligibility to those who qualify for family planning services. FSSA updates. Current offerings are posted here. Click here for a comparison of the available health plans. Health Insurance Portability and Accountability Act (HIPAA). POWER account contributions are a key part of the Healthy Indiana Plan. Not already Contracted to Sell for CareSource? CareSource-Brand-Logo-Vert-RGB-resize.png. There is a reason more Ohioans choose CareSource for their Medicaid plan than all other plans combined. Preadmission Screening and Resident Review (PASRR). The contribution that will be one of five affordable amounts between $1 and $20. Members normally served in Traditional Medicaid include individuals eligible for both Medicare and Medicaid, individuals who Home- and Community-Based Services (HCBS). Registration. The Postpartum Extension Demonstration waiver was developed from the passage of HB 1114 during Georgias 2020 legislative session. HIP provides incentives for members to take personal responsibility for their health. These remaining funds can be used to lower POWER account contributions for the next year of coverage. Registration. Find the forms you need to serve members and transact business with the IHCP. Providers can contact the Indianapolis Marriott East directly at reservations@indymarriotteast.com should they have issues with guest room reservations. Pregnant women who would otherwise be eligible for HIP but are not enrolled may receive a new member card indicating they are enrolled in HIP Maternity. After reporting a pregnancy, pregnant mothers will become HIP Maternity members. Managing your account well and getting preventive care can reduce your future costs. The IHCP is interested in hearing from you if you have input or need assistance. HIP Basic plan members will still receive POWER account statements to assist them in managing the account and to increase their awareness of the cost of the health care services they receive. Ordering, Prescribing or Referring Providers. EVV Service Providers; EVV Third-Party Information; EVV Schedule of Events; EVV Newsletter; PSS / CLS / Claims Implementation Archive (2018 2021) The IHCP participates in the federal Promoting Interoperability Program to provide incentives for eligible professionals and hospitals to adopt, implement, upgrade, or demonstrate meaningful use of certified electronic health records (EHR) technology. We care about you and your health. The changes have enhanced the individual and provider experience. Pregnant and new moms can earn up to $200 in rewards for keeping prenatal and well-baby visits. Members with income over the federal poverty level who do not pay for Plus will lose eligibility for HIP Basic after 60 days. These HIP State Plan benefits will continue as long as your health condition, disorder or disability status continues to qualify you as medically frail. If you choose to leave the program early, your contributions not spent on health care costs will be returned to you. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. A key principle of the Healthy Indiana Plan is that it gives members the opportunity to participate in HIP Plus. How you know. CareSource covers all medically necessary Medicaid-covered drugs at many pharmacies. Pregnant members will continue to not have any cost sharing responsibilities during this period. HIP Basic can be much more expensive than HIP Plus. The Georgia Department of Community Health (DCH) offers Planning for Healthy Babies to reduce Georgias low birth weight rate. The IHCP reimburses for long-term care services for members meeting level-of-care requirements. The provider search tool enables you to locate providers enrolled with the IHCP to provide services to Medicaid members. The IHCP is working in collaboration with stakeholders to expand and improve SUD treatment. Each health plan also has designated retail locations around the state where you can make your payment in person. Call 877-GET-HIP-9 to learn more about the application process or click here to find your local DFR office. Its because CareSource is more than just quality health care. It also allows more visits for physical, speech and occupational therapy, and covers additional services like bariatric surgery and Temporomandibular Joint Disorderstreatment. To receive notices, you must subscribe. Visit this page for information about upcoming webinars and recordings of past presentations. In HIP, if your annual health care expenses are less than $2,500 per year you may rollover your remaining contributions to reduce your monthly payment for the next year. At the end of her pregnancy, additional pregnancy benefits will continue for another 12 month post-partum period. Check this page for training opportunities around electronic visit verification (EVV) for personal care and home health services. Maintaining Your IHCP Provider Enrollment. HIP Basic does not cover vision, dental or chiropractic services and could be more expensive. The Presumptive Eligibility process allows qualified providers to make PE determinations for certain eligibility groups to receive temporary health coverage until official eligibility is determined. The Indiana Health Coverage Programs (IHCP) invites providers to attend the 2022 IHCP Works seminar from Oct. 11 through Oct. 13. Vision and dental care. information. An official website of the State of Georgia. The Medical Review Team determines an applicant's eligibility based on a disability. Nonemergency medical transportation services for most members served through the fee-for-service delivery system are brokered through Southeastrans Inc. A Notification of Pregnancy transaction helps identify risk factors in the earliest stages of pregnancy and thereby improve birth outcomes. Whether you're new to Medicaid or have been a provider for years, this section is designed to help answer your billing questions. Before sharing sensitive or personal information, make sure youre on an official state website. Meet CareSource PASSE Learn more about CareSource PASSE, a joint venture including CareSource and five Arkansas Medicaid providers of specialized health services. Third Party Liability Services Procurement, Childrens Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Health Insurance Premium Payment Program (HIPP), 2020 Georgia Families 360 Monitoring and Oversight Committee, 2019 Georgia Families 360 Monitoring and Oversight Committee, Georgia Medicaid Electronic Visit Verification, PSS / CLS / Claims Implementation Archive (2018 2021), Georgia Money Follows The Person (Ga MFP), Infant and Early Childhood Behavioral Health Services, Medicaid Enterprise System Transformation (MEST), Non-Emergency Medical Transportation FAQs, Non-Emergency Medical Transportation (NEMT) Procurement, Planning for Healthy Babies Program Overview, Planning For Healthy Babies Annual Reporting, Planning For Healthy Babies Semi-Annual Reporting, Planning For Healthy Babies Quarterly Reporting, Planning For Healthy Babies Summative Evaluation Reporting, Right from the Start Medical Assistance Group. FSSA updates. Providers are requested to register for the seminar online by using the Workshop Registration Tool. We care about you and your familys health and wellbeing. The Ohio Home Care Waiver Program case managed by CareSource has moved to a new system platform on April 1, 2021. The benefits are reduced. Copyright 2022 State of Indiana - All rights reserved. Find presentations from the most recent IHCP workshops and seminars are archived here. Indiana Family and Social Services Administration (FSSA) Benefits Portal. The member pays an affordable monthly POWER account contribution based on income. For information on contracting as a health partner, call 1-855-202-1058 or visitCareSource.com/providers/Georgia. Click here to access a calculator that will help you determine if you are eligible for HIP and will estimate your monthly POWER account contribution. The Healthy Indiana Plan is a health-insurance program for qualified adults ages 19-64. Family Member/Associate Transportation Providers. You can also double your reduction if you complete preventive services. The only exception to this is a copayment for going to the emergency room for care when there is not a true emergency. The Medical Review Team determines an applicant's eligibility based on a disability. The Healthy Indiana Planhas two pathways to coverage HIP Plus and HIP Basic. The Georgia Medicaid Management Information System (GAMMIS) serves as the primary web portal for Medicaid, PeachCare for Kids and all related waiver programs administered by the Department of Community Health's Medical Assistance Plans Division. HIP Plus provides MORE benefits than the HIP Basic program, including vision, dental and chiropractic services. If you are registering as a provider, select Practitioner and complete the information. Find presentations from the most recent IHCP workshops and seminars are archived here. Ordering, Prescribing or Referring Providers. Want to learn more about the benefits and services CareSource HIP and HHW members receive? It is important that you verify member eligibility on the date of service every time you provide services. They can help with employment, education, budgeting, food access, transportation, legal assistance, housing resources, childcare and more. Guest room reservations made on or before Sept.19, 2022, are available at a special rate of $146 plus state and local taxes, per night. HIP continues to build on the successes of the original design and lessons learned since initial implementation in 2008. Members who have incomes below the federal poverty level who do not make their contributions will be moved to the HIP Basic plan. The member will continue to have a POWER account but will not be required to make payments. There are two PDLs, depending on which plan you have. As an incentive, members who remain in the HIP Plus program can reduce their POWER account contribution amounts after a year in the program based on the amount remaining in their accounts. Gainwell Technologies and the Ohio Department of Medicaid (ODM) launched the Single Pharmacy Benefit Manager (SPBM) on October 1! What are the incentives for managing costs and receiving preventive care? The mission of the Program Integrity Unit is to guard against fraud, abuse, and waste of Medicaid program benefits and resources. Use the links on this page to access IHCP provider news items, bulletins, and banner page publications. An official website of the State of Georgia. Box 1307 Dayton, OH 45401-1307. CareSource. The 590 Program provides coverage for certain healthcare services provided to members who are residents of state-owned facilities. Copyright 2022 State of Indiana - All rights reserved. Choose the plan that gives you more! Help finding a job, finishing your degree or exploring a new career path with CareSource Life Services . Providers and their delegates can learn how to make the most of the IHCP Provider Healthcare Portal through web-based training sessions. To request a package by mail or a visit by one of our Georgia provider representatives, call us at 1-800-249-0442. Members can select their health plan when they apply. Click here to find monthly contribution amounts. Applications are available online or by mail, or can be picked up at any Division of Family Resourcesoffice. If you are registering as a provider, select Practitioner and complete the information. Before sharing sensitive or personal information, make sure youre on an official state website. The changes have enhanced the individual and provider experience. On an annual basis, HIP members have the opportunity to switch to another health plan for the following year. 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