Industry Updates: Qualified Provider HPE Metrics, CareSource, CoreMMIS, and MDwise Leaving Hoosier Care Connect

Qualified Provider (QP) Hospital Presumptive Eligibility (HPE) Metrics In the last quarter of 2016, letters were distributed by the state of Indiana FSSA to all acute care and psychiatric hospitals contracted as Qualified Providers (QPs) with the Medicaid Presumptive Eligibility (PE) program. These letters served as a “first warning” of non-compliance with state metrics and […]

FSSA Contact Pages

FSSA has a contact page on their website where you can submit inquiries or information related to a case. Some items you may inquire about are: Status of an application HIP POWER account payment confirmation Correcting HIP effective dates Reporting changes Some Advocates have had success in resolving issues with application by submitted inquiries though […]

New ACTS HIP Jail Suspended Reason

In response to popular demand, we’ve now added a HIP Jail Suspended Reason to the HIP Approval T-Code that should be used for ALL cases where an applicant receives the “…your HIP Application has been suspended because…” letter. Please have ALL of these accounts currently in PENDED status updated with this so that they will […]

Marketplace Special Enrollment Periods

  After Jan 31, consumers would need to qualify for a special enrollment period (SEP) in order to sign up for health coverage through the Marketplace. Consumers may be granted a SEP for certain life events that result in a change in family status or loss of other health coverage.  Consumers usually have up to 60 […]

CoreMMIS Set to Launch February 13th

  The Indiana Health Coverage Programs (IHCP) announced this week that it plans to launch the new CoreMMIS processing system on February 13, 2017. CoreMMIS is a modernized system that IHCP hopes will provide greater accuracy and efficiency in processing claims for services in alignment with coverage policies and national billing guidelines. With the new system, […]

HIP 2.0: New Logo, New Data

On January 24, 2017, Indiana Medicaid Director, Joe Moser, presented the new logo for the Healthy Indiana Plan 2.0 (HIP 2.0), as well as, new data about the current state of the program. Some highlights from the presentation are: 406, 323 members enrolled as of 1/16/17 64.5% are HIP Plus members 86% of HIP Plus […]

Changes to Authorized Rep form

After discussions with DFR leadership, it has been decided that ClaimAid Advocates should use an Authorized Representative (AR) form without a barcode, unless you have printed it from the submitted application and is thus linked to that specific case.  The generic AR form (with barcode) that we had been using was found to be scanning […]

2017 MCE Options for HHW and HIP Members

  FSSA has added a fourth Managed Care Entity (MCE) as an option for HHW and HIP members.  Effective January 1, 2017, the MCE options are now Anthem, CareSource, MDwise, and MHS. CareSource is the new MCE being offered and they began serving HHW members January 1, 2017 and HIP members on February 1, 2017.  Members […]

Rights and Responsibilities

FSSA state form 55367 explains the rights and responsibilities of an individual applying for an Indiana Health Coverage Program (IHCP). It is very important that you explain this document to the individuals we assist and give them a copy for their records.  The document prints when you choose the option to “Print Application” after you […]