Humana - CareSource strives to make it easy for you to work with us, whether online or over the phone.For questions not addressed on our website, please call Provider Services at 1-800-488-0134.1-844-679-78651-855-852-55581-844-607-28311-866-286-99491-855-202-10581-855-202-10911-855-852-70051-844-539-17291-833-230-21761-833-230-2155 You can . The IHCP provider enrollment instructions and processes are outlinedon these web pages. This item is may be covered by Medicare, Medicaid or your commercial insurance plan.If . Initial Complaint. Indiana Medicaid. stream The Healthy Indiana Plan is a health-insurance program for qualified adults ages 19-64. The information that identifies and describes an enrolled IHCP provider is called a Provider Profile. Submit this Navigate Find links to provider code sets, fee schedules and more. Questions? Any inaccurate demographic information (phone number, address, etc.) Indiana Medicaid provides a healthcare safety net to Hoosier children, aged, disabled, pregnant women, and other eligible populations under the umbrella of Indiana Health Coverage Programs (IHCP). Medicare Savings Programs pay Medicare coinsurance, deductibles, and/or premiums for qualified elderly and disabled individuals. All your information must match exactly as listed on your Explanation of Benefit (EOB) or welcome letter from CareSource. Provider Services can also help with obtaining a unique CareSource portal ID for registration and log on. You will receive a response within one business day. % Contact Information. Additional information can be found in the prior authorization section on the portal. For more information about drugs that require prior authorization, access our Pharmacy webpage. Click belowto see more! Ms. Jenny Michael, SVP, Advocacy; Mr. Erhardt Preitauer, President/CEO; . Claims Search, EOP & Submissions. Complete an IHCP Provider Enrollment Application. This list is not inclusive of every health care service with a telehealth component. The IHCP reimburses for long-term care services for members meeting level-of-care requirements. With more than 100,000 network providers across the coverage areas, and depending on your plan, you have plenty of choice when it comes to finding the best care available to meet your health needs. Navigate The Right Choices Program monitors member utilization and, when appropriate, implements restrictions for members who would benefit from increased case coordination. IHCP-enrolled providers interested in enrolling as a provider for Healthy Indiana Plan (HIP), Hoosier Healthwise, or Hoosier Care Connect members must apply directly to one or more of the managed care entities (MCEs). Territory Map. HCBS programs are intended to assist a person to be as independent as possible and live in the least restrictive environment possible while maintaining safety in the home. Register for an account. 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 reset password email will come from a sender titled. New Provider Setup: Check Enrollment Status. New Provider Setup: Check Enrollment Status. CareSource is excited to announce additional enhancements for the Provider Portal. doctor, request an ID Card and more. Your Gainwell provider relations consultant . Preadmission Screening and Resident Review (PASRR). The provider search tool enables you to locate providers enrolled with the IHCP to provide services to Medicaid members. Customer Contact. If you send us your question or request on a Friday, you will receive a response by Monday of the next week. Learn about the many ways to contact the Indiana Health Coverage Programs (IHCP). <>/Metadata 1143 0 R/ViewerPreferences 1144 0 R>> We believe in benefits without boundaries. Enroll as a provider with the IHCP to bring critical medical care to eligible Hoosier children and adults. Press Enter again after expanding an item to navigate to that page. Visit this page for information about upcoming webinars and recordings of past presentations. CareSource accepts claims in a variety of formats, including online and paper [] Step-by-Step Guidance: Register for the Provider Portal. The Provider Portal makes it easier for you to work with us 24/7. In addition to information about how to submit claims and check payments, CareSourceoffers you tools to find specific information, such as claim status and member coordination of benefits (COB) status. The IHCP will implement an electronic visit verification (EVV) system for federally required provider documentation of designated personal care and home health services. with up to 5 times the number of maximum matches per search vs. non-subscribers. The Indiana Health Coverage Programs (IHCP) has a specific process for members, providers, or other interested parties who would like to submit requests for policy consideration. Find clinical tools and information about working with CareSource. 06/17/2022. It can also be used to review or modify a registration. Go to https://www.caresource.com/providers/contact-us/. Low-income individuals who don't qualify under another eligibility category may qualify for family planning services under the Family Planning Eligibility Program. link to reset your password, or you can wait 24 hours and attempt to log in again. Enroll with ECHO for payment and choose EFT as your payment preference for CareSource. CareSource also partners with Availity to offer electronic claim submission and real-time transactions at no charge through theAvaility Portal. If you do not see the email in your inbox, do one of the following: Confirm you are using the same email address that you registered with. Filing Jurisdiction, Entity Type, Registered Agent, File Number, Filing Status, and Business Category. You can also review theWaiver Services Claim Entry and Service Plan Trainingpresentation. CareSource would like to remind all MyCare Waiver providers that all waiver codes require a prior authorization. Your entire office will be able to use your search subscription. Press Enter or Space to expand a menu item, and Tab to navigate through the items. Prior Authorization Search & Submissions. Box 8730Dayton, OH 45401-8730Fax: 937-224-3388. Caresourcer.com uses Cookies to provide you with the best experience we can and to continue to improve the site.. . Humana - CareSource strives to make it easy for you to work with us, whether online or over the phone. Contact Us | CareSource best www.caresource.com. Prior authorization is required for certain covered services to document the medical necessity for those services before services are rendered. We administer one of the nation's largest Medicaid-managed care plans and offer access to care through health insurance, including Medicaid, Health Insurance Marketplace, Medicare Advantage and dual-eligible programs. The company's filing status is listed as Active and its File Number is 604589175 . Member & Eligibility Search. The Medical Review Team determines an applicant's eligibility based on a disability. The Workshop Registration Tool enables providers to sign up for workshops. WAIVER Providers must have a National Provider Identifier (NPI) by Oct. 1, 2021 or claims will be denied. 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. These provider education training links cover topics such as documentation requirements, billing guidelines, and other program integrity- and audit-related issues. . Navigate Contact Information. CareSource has partnered with ECHO Health, Inc. to deliver provider payments. If you have questions about IHCP provider enrollment, enrollment status or provider profile updates, call Customer Assistance at 800-457-4584 and select option 2, and then option 1 to check provider enrollment status or option 3 to update provider enrollment information. This site is protected by reCAPTCHA and the Google. In addition to initiating your prior authorization request through the provider portal, you can now submit requests to update your authorization requests. Providers and their delegates can learn how to make the most of the IHCP Provider Healthcare Portal through web-based training sessions. In addition to information about how to submit claims and check payments, CareSource offers you tools to find specific information, such as claim status and member coordination of benefits (COB) status. Providers can get help by calling Provider Services at 1-800-488-0134. Indiana Medicaid Promoting Interoperability Program. My CareSource , your personal online account.. Get the most out of your member experience. Prior Authorization Search & Submissions. To protect our site, we cannot process your request right now. There will be new individual and provider portals that will look and act differently. The Preadmission Screening and Resident Review process is a requirement in all IHCP-certified nursing facilities, prior to admission or when there is a significant change in the physical or mental condition of a resident. CareSourceaccepts claims in a variety of formats, including online and paper claims. Find presentations from the most recent IHCP workshops and seminars are archived here. Not already Contracted to Sell for CareSource? April 28th 2022 I requested a refund from Caresource due to overpayment of $510.28. Whether you're new to Medicaid or have been a provider for years, this section is designed to help answer your billing questions. Outpatient practices may register as Practitioner to create a portal account for the practice Tax ID. All rights reserved. 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. check your deductible, change your Established in 1989. Sign up for email and/or text notices of Medicaid and other FSSA news, reminders, and other important Copyright 2022 State of Indiana - All rights reserved. The Registered Agent on file for this company is Corporation Service Company and is located at 300 Deschutes Way Sw Ste 208 Mc-Csc1, Tumwater, WA 98501. Local, state, and federal government websites often end in .gov. While logged in and authenticated, you will not be asked to solve any complicated Recaptcha V2 challenges. The changes have enhanced the individual and provider experience. The changes have enhanced the individual and provider experience. If the Tax ID for your facility or practice has already created an account to utilize the CareSource Provider Portal, a new account cannot be created. The Indiana Health Coverage Programs (IHCP) invites providers to attend the 2022 IHCP Works seminar from Oct. 11 through Oct. 13. Payment Review Tool Use this tool to reference CareSources pre- and post-payment review processes and appropriate contacts. The mission of the Program Integrity Unit is to guard against fraud, abuse, and waste of Medicaid program benefits and resources. company profile page along with the rest of the general data. 4 0 obj You can submit claims and any necessary attachments, track claim payments and more. You can use theAvaility Portal Registration Guide to get signed up. The Health Insurance Portability and Accountability Act (HIPAA) contains the provisions for portability, Medicaid integrity, and administrative simplification. Overpayment Recovery Form Submit this form to offset overpaid claims against a future payment. A Member Services representative will be happy to answer your questions Monday through Friday, 8 a.m. to 8 p.m. unless otherwise stated below. We want to make it as easy as possible to conduct business with us. You will use this paper claim process until you can log in to the Provider Portal and access your service plan. ^&w5A[N&{:`s =HvdERG;5`Ov%~bzv Press Escape to collapse the expanded menu item. Get Contracted by following the link below. The 590 Program provides coverage for certain healthcare services provided to members who are residents of state-owned facilities. Call ECHO Customer Support at 1-888-834-3511. Provider Services can also help with obtaining a unique CareSource portal ID for registration and log on. To learn more, view the network notification. This number is only for service plans and NOT claim submissions. The company's principal address is 740 Se Seventh . Indiana Medicaid for Providers. Provider Enrollment Inquiries. Claim your free profile. endobj PCP Roster & Clinical Practice Registry. endobj CareSource Medline is a Medicare and Medicaid participating supplier in some states. We want to make it easy for you to stay aware of any changes with CareSourceplans, as well as new processes we create to make doing business with us more efficient. ECHO offers three payment options: *Payment processing fees are what you pay your bank and credit card processor for use of payment via credit card. Family Member/Associate Transportation Providers. Find the forms you need to serve members and transact business with the IHCP. They issued a . information. Policy Consideration Requests. Ordering, Prescribing or Referring Providers. When registering your email, check the category on the drop-down list to receive notices of CareSource has partnered with Pulse8 and we are offering on line ICD-10-CM diagnosis coding and Risk Adjustment education sessions and webinars. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 21 0 R 22 0 R 28 0 R 29 0 R 30 0 R 31 0 R 34 0 R 35 0 R 36 0 R 42 0 R 43 0 R 44 0 R 45 0 R 46 0 R 47 0 R 48 0 R 49 0 R 50 0 R 51 0 R 52 0 R 53 0 R 54 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> CareSource encourages providers to use the Pregnancy Risk Assessment Form (PRAF 2.0) decrease preterm births by facilitating progesterone treatment. We are sorry, but your computer or network may be sending automated queries. It has critical information and tools to save your practice time. CareSources traditional providers, community partners and delegates and health homes all may submit claims through the CareSource Provider Portal using onlineforms. * Change your doctor Request a new ID card View claims and plan details Update your contact information And more Login Sign Up. Learn about the many ways to contact the Indiana Health CoveragePrograms(IHCP). Find important information for providers, software developers, and trading partners that communicate via electronic data interchange format and direct data entry. CareSource is excited to announce additional enhancements for the Provider Portal. If you are unable to log in to the Provider Portal and access your service plan, use theCMS 1500 Health Insurance Claim formto expedite your claim payment. IHCP Live webinars offer providers an opportunity to learn about new policy initiatives and billing guidance. Caresource Management Services LLC is a Washington Foreign Limited-Liability Company filed On March 18, 2020. Program Integrity Provider Education Training. To ensure that we have the most up-to-date service plan for our MyCareOhiomembers, please fax your service plan to 937-487-0936. <> The Ohio Home Care Waiver Program case managed by CareSource has moved to a new system platform on April 1, 2021. Enrolling as a Managed Care Program Provider. The Preferred Diabetes Supply List helps ensure that IHCP members receive the highest quality products at the lowest cost. Instructions for submitting claims and/or appeals for denial of claims can be found onthe Provider Portal. Check this page for training opportunities around electronic visit verification (EVV) for personal care and home health services. The .gov means it's official. Status: Resolved. Complaint Type: Problems with Product/Service. The IHCP is working in collaboration with stakeholders to expand and improve SUD treatment. Providers are responsible for keeping all the information in the Provider Profile up-to-date. Provider Relations regions are organized to minimize provider wait times when providers need assistance. PACE provides community-based care for qualified members who are 55 and older that live in a PACE service area. PCP Roster & Clinical Practice Registry. Members normally served in Traditional Medicaid include individuals eligible for both Medicare and Medicaid, individuals who Home- and Community-Based Services (HCBS). Register for an account. CareSource Find a Doctor. If you get a message that you are already registered, go to the, If you get a message that the provider does not exist in Provider Portal, you can call the help line at, Locate the email in your email inbox to reset your Provider Portal password. Providers have the option to submit claims through our secure, online Provider Portal. With the Bizapedia Pro Search service you will get unlimited searches via our various search forms, Payment Review Tool Use this tool to reference CareSources pre- and post-payment review processes and appropriate contacts. Open 8 a.m. to 8 p.m. Eastern time, Monday through Friday The Registered Agent on file for this company is Twila Farris and is located at 740 Se Seventh Street, Grants Pass, OR 97526. For all high tech radiology: CT, CTA, MRI, MRA and PET scans; providers should contact NIA or their web portal at www.radmd.com. * Change your doctor; Request a new ID card; View claims and plan details; Update your contact information Type the email address that you want associated to your Provider Portal account. All claims for waiver services reimbursement or appeals for claim denials should be submitted electronically through ourProvider Portal. You can accessinstructionsto complete the form and a list of valid service codes. Traditional Medicaid is a program created to provide health care coverage to individuals who are not enrolled in managed care. Medicaid updates; check other areas of interest on the drop-down list to receive notices for other types of The email notifications are used to send notices to subscribers on behalf of the IHCP. Electronic Data Interchange (EDI) Solutions. IHCP providers should verify enrollment of the ordering, prescribing or referring (OPR) provider before services or supplies are rendered. Step-by-Step Guidance: Register for the Provider Portal. Get answers to the most frequently asked questions about the IHCP. The IHCP allows a family member or close associate of a Medicaid member to officially enroll as a driver, so the driver's mileage can be reimbursed. Questions? Your Group Name, Tax ID, Provider ID and ZIP Code must match exactly as listed on your Explanation of Benefit (EOB) or welcome letter from CareSource. MA - Dual Special Needs: 1-833-230-2020 (TTY: 1-800-743-3333 . In addition to initiating your prior authorization request through the provider portal, you can now submit requests to update your authorization requests. For example, you will now be able to add additional documentation or change dates of service. Step 1 of 3 - Provider Eligibility. 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. CareSource has developed the Telehealth HEDIS Measure Quick Reference Guide to provide guidance for activities where telehealth visits, and their related claims, may contribute to measurable quality outcomes in HEDIS (Healthcare Effectiveness Data and Information Set). CareSource offers this service at no cost. The IHCP is interested in hearing from you if you have input or need assistance. Caresource Health Plan is an Oregon Assumed Business Name filed On November 19, 2004. provider manualfor detailed information to submit claims. Providers can find pharmacy benefit information for the program/health plan with which the member is enrolled. Three types of claims may be submitted: For a detailed explanation of how to submit claims using online forms, please see the CareSource Provider Portal Claim Submission User Guide. If you do not see the activation email in your Inbox, do one of the following: Confirm that you have entered the email you registered with. 1 0 obj if we've collected "Sales Lead Information" for a given company, it will be displayed on the The landscape of telehealth has quickly evolved over the past year. Provider Relations Consultants. IHCP reimbursement for services or medical supplies resulting from a practitioner's order, prescription or referral requires the ordering, prescribing or referring (OPR) provider to be enrolled with the IHCP. Learn more: PRAF Informational Webinar. All rights reserved. Use the portal to pay your premium, q*,Ym80Lei2&Aei(P;-:bh'K3$Fb0U#G,;Qs.<2L Medicare Advantage: 1-844-607-2827 (TTY: 1-800-743-3333 or 711) Hours: 8 a.m. to 8 p.m. EST, seven days a week from October 1 to March 31, and Monday - Friday the rest of the year. In addition, all pages on Bizapedia will be To register on the Provider Portal, complete the following steps: If you are locked out of your account due to too many incorrect login attempts, or you do not remember your password, you can reset your password by following these steps: If your account is locked due to too many login attempts, use the Forgot password? FSSA updates. CareSource is a nonprofit, multi-state health plan recognized as a national leader in managed care. o9hnplU )ev9NQgz?Y_Rt &si5Z +{V0K`^^7*7 P?$vhN77nqVYOQvMz9Z e-| `BJoK$\3wFhd7H1l:tQ"8vvc{T{~v [*Bk' #G,!Riu I;7sIK57tt2.u For questions not addressed on our website, please call Provider Services at 1-800-488-0134.1-844-679-78651-855-852-55581-844-607-28311-866-286-99491-855-202-10581-855-202-10911-855-852-70051-844-539-17291-833-230-21761-833-230-2155 You can reach us Monday through Friday from 8 a.m. to 6 . if the company chooses to hide the private information on their profile from the general public. Tell Us. Health Insurance Portability and Accountability Act (HIPAA). 9ZYxl FdUgzhPh Providers must be enrolled as MRT providers to be reimbursed for MRT services. Recent policy changes have expanded the use of telehealth to deliver acute, chronic, primary and specialty care to preserve and support the patient-provider relationship. For the most efficient processing of your claims, CareSource recommends you submit all claims electronically. Providers interested in becoming qualified providers (QPs) for presumptive eligibility (PE) must complete an application through the IHCP Portal and contact IHCP Provider Relations to arrange training. After you complete the paper claim form, you may either mail it or fax it for processing: CareSourceAttn: Claims DepartmentP.O. Qualified Provider Presumptive Eligibility (PE). Reference our Dental Provider Manual for dental services that require prior authorization. The email you enter is used to send your user account activation. . 3 0 obj Use the links on this page to access IHCP provider news items, bulletins, and banner page publications. To receive notices, you must subscribe. Paper claim forms are encouraged only for services that require clinical documentation or other forms to process. They issued a . 011 888 0246 / 061 516 6878. To find the direct phone numbers for your needs, please visit the Contact Us pages shown under . x}]s6}[>[M|[Su8x{wjg/[cIYLyI2r,i4F'ww_9W7_?^4/W_~;p_0\{1eDo34w_Np?O/xp_gztQ>8|o// :h1I~FJ8IIt[)]~Ff8 5j3Oo(] q[L=zx\y30?gv5{kxYzx4nMu 5Y=hPZ>;+HJW$JuF4=nUM:,LGp01]RjNBUe!RFt r-= Refer to the provider manualfor instructions to submit paper claims. IHCP Quick Reference Guide. Current offerings are posted here. Program for All-Inclusive Care to the Elderly (PACE). Utilize our advanced search form to filter the search results by Company Name, City, State, Postal Code, If you are in need of enterprise level search, please consider signing up for a Bizapedia Pro Search account as described on this page. RANDBURG HEAD OFFICE. The Webinar details: Learn more about this great educational opportunity and register for the webinars. served to you completely ad free and you will be granted access to view every profile in its entirety, even Enrollment transaction submissions are needed to enroll, add a service location, report a change of ownership, revalidate, or update provider profile information. For your ZIP code, if you have multiple addresses in your profile, any ZIP code from the profile will work. We encourage you to submit claims online to take advantage of the following benefits: Refer to the Navigate Network Notifications are published to communicate updates that impact claims, clinical guidelines, Provider Portal functions and more. To create your user account, do the following: Must contain one lowercase letter, one uppercase letter, one digit and one non-alphanumeric character. cover sheet and itemized statement for high dollar claims.
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