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Indiana Hoosier Healthwise (Medicaid and SCHIP)

PW_AD089430

Provider Resources

Hoosier Healthwise is Indiana’s health care program for children, pregnant women and low-income working families. It is a complex network of public and private health care providers who serve Indiana’s citizens. If you would like more information about this initiative, you may go to http://www.in.gov/fssa/ompp/2544.htm or call 1-800-889-9949. 
The Healthy Indiana Plan (HIP) was created by the Indiana State Legislature and uses cigarette tax revenues to help fund health care benefits for those adults who have traditionally been uninsured. Anthem Blue Cross and Blue Shield is one of the plans selected by the state to administer this program. If you would like more information about this initiative, you may go to: http://www.in.gov/fssa/hip/ or www.hip.in.gov or call 1-877-GET HIP9 (1-877-438-4479). 
 
Important Information for Providers 
ICD-10: Click here for the latest information on ICD-10 
EDI/HIPAA 5010: Click here for the latest information on HIPAA 5010  
 

Quality Improvement Program

Date

Format

Medicaid Random Medical Record Review Process

   

Summary of Provider Credentialing Program

04/10

PDF

QIP Summary

06/12

PDF

HEDIS Descriptions

09/09

PDF

HEDIS Measure Physician Documentation Guidelines and Administrative Codes

11/09

PDF

Clinical Practice Guidelines

-

-

Preventive Health Care Guidelines

-

-

Behavioral Health Clinical Practice Guidelines

   
 

Prior Authorization and Preservice Review

Date

Format

Universal Authorization Form

-

PDF

07/13

PDF

Request for Preservice Review Form

08/08

DOC

Prior Authorization Toolkit

-

-

Utilization Management Clinical Guidelines

08/13

PDF

HIP Precertification List for 2008

-

PDF

 

Health Education

Date

Format

Caring for Diverse Populations

09/13

PDF

Webinars and Presentations

-

-

40 Weeks of Pregnancy…Every Week Counts Reducing Elective Inductions Prior to 39 Weeks

04/12

PDF

Employee Language Skills Self-Assessment Tool

09/12

PDF

EPSDT HealthWatch Information

-

-

VFC Program Update

04/09

PDF

Health Education Programs

-

-

Interpreter Services

-

-

Indiana Medicaid Smoking Cessation Program

06/07

PDF

 

Provider Communications

Date

Format

Provider Manual and Important Updates

-

-

Provider Newsletters

-

-

 

Additional Programs and Services

Date

Format

Community Resource Coordinators' Roles and Responsibilities

01/11

PDF

Pharmacy Information

-

-

 

Behavioral Health

Date

Format

10/12 
PDF 
 

Forms and Tools

Date

Format

Coordination of Care Form and Letter Templates

-

-

McKesson ClaimsXtenTM Rules

09/12

PDF

Tour Our Anthem State Sponsored Plans Provider Website

10/12

PDF

Forms Library

-

-

How to Find Preventive Care Forms Online

3/13

PDF

Hoosier Healthwise Provider Directory

-

PDF

Member Handbook / Evidence of Coverage – Medicaid

-

PDF

Member Handbook / Evidence of Coverage – SCHIP

-

PDF

Important Phone Numbers

-

-

Benefits Matrix for Healthy Indiana Plan Members

01/11

PDF

Benefits Matrix for Hoosier Healthwise Members

01/11

PDF

Member Rights and Responsibilities
Please refer to the Provider Manual, Chapter 21: Members Rights and Responsibilities

 

PDF

 

Standards and Policies

Date

Format

02/08

PDF

Advance Directives

11/10

PDF

National Provider Identifier (NPI)

-

-

Notice of Privacy Practices (NOPP)

07/07

PDF

HIPAA Readiness Disclosure Statement

-

PDF

Anthem Medical Policies

-

-

 

How to Contract with Anthem

Date

Format

2011 Contracting to Continue serving HHW and HIP Letter

-

PDF

2011 HIP Professional Unilateral Amendment

-

PDF

2011 Medicaid Professional Unilateral Amendment

-

PDF

2011 HHW HIP Unilateral Amendment Letter

-

PDF

Changes Lives Together

06/10

PDF

Recontracting for 2011

03/10

PDF

About Anthem

11/06

PDF

You are an Essential Part of our Network

-

-

Request for Professional Provider Practice Information Form

07/08

DOC

Adding a New Provider to Your Group or Joining a Group

-

PDF

02/11

PDF

03/12

PDF

03/13

PDF

06/14

PDF

CMS Disclosure of Ownership Form

-

DOC

Indiana Professional Fee Schedule for Medicaid Services
After entering the IHCP website, click the link “Fee Schedule” link on the right side bar, accept the terms and follow the instructions to see Medicaid reimbursement rates.

-

-

 
If you have any questions, please call 1-866-408-6132.
If your patients have questions about Anthem, please ask them to call
1-888-232-9613 (TTY 866-408-7188).
 
Last Update: 03/24/10 Version: 29  
©2005-2014 copyright of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use