The Indiana Health Coverage Programs (IHCP) uses the online IHCPProvider Healthcare Portal (IHCPPortal) as an interface between providers and the Core Medicaid Management Information System (CoreMMIS). CoreMMIS allows the IHCP to perform program management functions, including to accurately and efficiently adjudicate claims in alignment with IHCP coverage policies and national billing guidelines. The IHCP Portal is an interactive, secure and easy-to-use tool for providers and other partners to exchange information with the IHCP through the internet.
Providers that wish to enroll in the IHCP can use the IHCPPortal to submit an application. After the application is approved, the enrolled provider can then establish a secure IHCPPortal account through which the following transactions can be performed:
- Verify member eligibility and view details about the member's coverage
- Submit fee-for-service (FFS), nonpharmacy claims and claim adjustments; view claim status and history
- View Remittance Advice (RA) and payment information for FFS, nonpharmacy claims
- Submit provider referrals to be added to a Right Choices Program (RCP) member's lock-in list (RCP primary medical providers [PMPs] only)
- Submit and view Notifications of Pregnancy (NOPs) for managed care members (certain provider types only)
- Submit Presumptive Eligibility applications (qualified providers only)
- Update enrollment information in the provider profiles
- Submit secure correspondence (claim-related correspondence limited to FFS, nonpharmacy only)
Note: The IHCP Portal is maintained by Gainwell Technologies. See the Portal Links for Providers page for links to portals maintained by other IHCP contractors, for functions such as FFS prior authorization, electronic visit verification (EVV), pharmacy transactions, nonemergency medical transportation brokerage and certain long-term care functions. For managed care entity (MCE) portal links and contact information, see the IHCPQuick Reference Guide.
Establishing a Secure IHCP Portal Account
Authorized representatives and delegates can access the IHCPPortal to register a secure account or log in to an existing account.
Provider Account
Providers are required to create a unique, secure Provider account on the IHCPPortal for each IHCP-enrolled service location. Providers must designate a representative to register the Provider account in the IHCPPortal. One person can serve as the representative on multiple Provider accounts for providers that have more than one service location.
The provider representative has full access to all information and IHCPPortal functions related to the service location and can assign and manage delegates with varying degrees of portal access for a service location. The role of representative should not be assigned to trading partners or contractors. All provider staff should be made aware of the designated representative for security purposes.
After being selected, the provider representative must register the Provider account for the service location. Each service location is limited to one Provideraccount.
Delegate Account
A delegate is anyone other than the Provider account representative who is designated to work in the provider's IHCPPortal account for a specific service location. Before they can register an account, all delegates must be authorized and assigned delegate permissions in the IHCPPortal, either by an account representative or by a previously authorized delegate with permissions to add additional delegates. When a new delegate is authorized for an IHCPPortal account, the system generates a unique delegate code, which must be provided to the delegate along with instructions to register a Delegate account in the portal.
The IHCP Portal can be accessed by anyone with a current Delegate account. It is the responsibility of the provider representative to ensure that delegate access is added and removed (deactivated), as appropriate, when staff changes occur.
More Information
The IHCPPortal is compliant with Health Insurance Portability and Accountability Act (HIPAA) requirements for direct data entry (DDE). Encryption and secured socket layer (SSL) connections protect the data in transit. HIPAA security regulations require that passwords are not shared; therefore, each user of the IHCPPortal must have a unique userID. For security purposes, IHCPPortal passwords must be reset every 60 days. Password resets and other portal account maintenance can be performed online.
Technical questions about registering or maintaining IHCPPortal accounts should be referred to the Electronic Solutions technical assistance line by calling 800-457-4584 (press option 3, then option 2 to reach an IHCP Portal representative).
The IHCPPortal itself includes online help functions to assist users. In addition, more information about the IHCPPortal is available as follows:
- Consult the IHCPPortal FAQs for information about registering and managing accounts on the IHCPPortal.
- Take the web-based trainings and review the quick reference guides on the IHCPProvider Healthcare Portal Training page to learn about various aspects of the IHCPPortal.
- See the Provider Healthcare Portal IHCP provider reference module.
- Refer to IHCPBannerPages andIHCPBulletins – search for the keyword "portal."
- Contact the IHCPProvider Relations consultant in your area.
