IN IHCP MCE Hospital/Ancillary Provider Enrollment and Credentialing Form 2020 free printable template
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ICP MCE HOSPITAL/ANCILLARY PROVIDER ENROLLMENT AND CREDENTIALING FORM Please select the Indiana Health Coverage Programs (ICP) managed care program(s) for which this form applies: Healthy Indiana
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How to fill out IN IHCP MCE HospitalAncillary Provider Enrollment and
How to fill out IN IHCP MCE Hospital/Ancillary Provider Enrollment and Credentialing
01
Obtain the IN IHCP MCE Hospital/Ancillary Provider Enrollment and Credentialing application form.
02
Fill out the basic information section, including name, contact details, and facility information.
03
Provide all required documentation, including licenses, certifications, and proof of insurance.
04
Complete the provider type section, specifying whether you are a hospital or ancillary provider.
05
Detail the services offered and any specialties your facility may have.
06
Ensure all information is accurate and complete to avoid delays.
07
Review the application thoroughly before submission.
08
Submit the completed application and required documents to the designated regulatory body.
09
Await confirmation and follow up if necessary to check the status of your application.
Who needs IN IHCP MCE Hospital/Ancillary Provider Enrollment and Credentialing?
01
Hospitals seeking to participate in the Indiana Health Coverage Programs.
02
Ancillary providers (such as outpatient clinics, labs, etc.) looking for credentialing and enrollment.
03
Healthcare organizations that want to serve Indiana Medicaid patients.
04
Providers needing to establish their eligibility and compliance with state regulations.
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People Also Ask about
How long can you stay on Medicaid in Indiana?
Eligibility factors Age - These programs serve children through the age of 18. Current health insurance coverage - Having private insurance may affect eligibility. Income - See limits below.
How long does it take to get approved for Medicaid in Indiana?
Waiting Periods in CHIP StateWaiting Period prior to January 1, 2014Waiting Period as of April 2021Indiana3 months90 daysIowa1 month1 monthKansas8 months90 daysKentucky6 monthsNone37 more rows
How do I get a Medicaid number in Indiana?
Traditional Medicaid members should contact the Traditional Medicaid Member Services and Pharmacy Services line. A complete list of phone numbers is provided below.Contacts by Health Plan: MHSMember Services (Healthy Indiana Plan)877-647-4848Member Services (Hoosier Care Connect)877-647-48484 more rows
What is the maximum income to qualify for Medicaid in Indiana?
Income & Asset Limits for Eligibility 2023 Indiana Medicaid Long-Term Care Eligibility for SeniorsType of MedicaidSingleMarried (both spouses applying)Income LimitAsset LimitInstitutional / Nursing Home Medicaid$2,742 / month*$3,000Medicaid Waivers / Home and Community Based Services$2,742 / month†$3,0001 more row • Feb 27, 2023
What documents are needed for Medicaid application in Indiana?
INFORMATION REQUIRED TO COMPLETE THE INDIANA MEDICAID APPLICATION Names and dates of birth. Social Security Numbers. Income from jobs or training. Benefits you get now (or got in the past), such as Social Security, Supplemental Security Income (SSI), veteran's benefits, or child support.
What does Medicaid pay for in Indiana?
Hoosier Healthwise Indiana Medicaid plans covers medical care like doctor visits, prescription medicine, mental health care, dental care, hospitalizations, surgeries, and family planning at little or no cost to the member or the member's family.
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What is IN IHCP MCE Hospital/Ancillary Provider Enrollment and Credentialing?
IN IHCP MCE Hospital/Ancillary Provider Enrollment and Credentialing is a process through which hospitals and ancillary providers are enrolled in the Indiana Health Coverage Programs (IHCP) managed care entities (MCEs) to provide services to Medicaid beneficiaries.
Who is required to file IN IHCP MCE Hospital/Ancillary Provider Enrollment and Credentialing?
All hospitals and ancillary providers who wish to participate in the Indiana Health Coverage Programs (IHCP) and offer services to Medicaid beneficiaries are required to complete the enrollment and credentialing process.
How to fill out IN IHCP MCE Hospital/Ancillary Provider Enrollment and Credentialing?
To fill out the IN IHCP MCE Hospital/Ancillary Provider Enrollment and Credentialing, providers must complete the necessary application forms, provide required documentation such as licenses and certifications, and submit the application to the respective MCE for review.
What is the purpose of IN IHCP MCE Hospital/Ancillary Provider Enrollment and Credentialing?
The purpose of IN IHCP MCE Hospital/Ancillary Provider Enrollment and Credentialing is to ensure that healthcare providers meet specific standards and qualifications to deliver safe and quality services to Medicaid recipients.
What information must be reported on IN IHCP MCE Hospital/Ancillary Provider Enrollment and Credentialing?
Providers must report various information during the enrollment and credentialing process, including provider demographics, licenses, certifications, ownership information, and any previous disciplinary actions or malpractice history.
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