You may assist with a pt’s HIP coverage to be considered and expanded to HIP State Plan by contacting the MCE and submitting documentation to support the pt’s health conditions.
Please use the contact information below when submitting documentation.
Most everything goes through one person, Michelle Warner. Her contact info is:
877-647-4848 ext. 20691
They have more of a team approach and prefer things to be mailed (especially if it’s more than just a few pages).
Attn: Medically Frail Coordination Team
PO Box 44236
Indianapolis, IN 46244
Contact is Barb Shull
If she is not available, the team can be reached at 317-822-7577
Fax: 317-715-4215 or 844-407-6455
Anthem – HIP
Anthem Transition Unit is responsible for determining medically frail status.
Their phone # is 844-276-3509. Fax # is 317-287-6153.
The mental health criteria that will be reviewed includes:
- Diagnosis(es)- it is assumed these are MRO billable dx
- Documentation of current active treatment- specifically with a MD psychiatrist
- List of current medications
- Statement of whether there is current active psychosis or not
- Single episode of suicide attempt requires documentation of date of event
- Multiple suicide attempts are an automatic enrollment into Medically Frail status!!!
This information will be collectively listed in: treatment plan, BPSE, medication list, progress notes (doctor and therapy within past few months). The ANSA functional assessment might be good to include as well.