What should I do if HPE coverage terminates incorrectly?

We have heard from some of you that recently HPE members’ temporary coverage is being terminated at the end of the month following the HPE approval despite their timely filed full applications either remaining in pending or conditional status.  OMPP has been made aware of this and will be researching the cause. If this occurs […]

What does the “Medical Review Team” note in CoreMMIS mean?

Question: If you are verifying eligibility for a patient in the new CoreMMIS Portal and you see “Medical Review Team” displayed under the Coverage section, what does that mean? a)  The patient is enrolled in Medicaid for the Disabled b)  The patient is being evaluated for IHCP eligibility c)  You need to call the Medical Review […]

What happens when IHCP members reach their cost-sharing limit?

Indiana Health Coverage Programs (IHCP) members reaching 5% of the Medicaid household income in a given quarter will receive written notice informing them that cost-sharing obligations are suspended for the remainder of the current quarter. The written notice will name the affected member, and the date of the notice will establish the calendar quarter affected. […]

How can I prevent FSSA denials for failure to verify residency?

It is our understanding that FSSA has changed their policy on verifying IN residency when photo ID provides a different address than reported.  We understand that FSSA  will accept a signed statement from the applicant unless residency  is questionable. Please have the patient sign a statement reporting their address that you can then send to […]

Fast Track Payment Questions

What information is requested at the time we are submitting the FT payment on line with the HIP application? Each MCE may have some slight differences but they all ask for the card #, type (VISA or Mastercard), expiration date of the card and name on card. This can be the hospital foundation name or […]

What if WebInterchange does not provide the PE option?

Sometimes WebInterchange will not provide the Presumptive Eligibility (PE) option after you search an individual in their system. If the PE option does not appear after searching by the individual’s social security number or name and date of birth, inquire if the individual had previously been issued a RID number.  If they had, try searching […]

What do I do if the patient was assigned to the incorrect MCE?

If your patient chose a specific MCE at time of application and was incorrectly assigned to a different MCE, you should first contact FSSA to request that they correct the error.  You can contact FSSA by phone or by emailing the appropriate DFR mailbox.  You may need to provide proof that you selected the specific […]