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News

ARTICLE

Date ArticleType
2/18/2016 Professional Interest Sections

Transition to CoreMMIS and the Provider Healthcare Portal

 
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Transition to CoreMMIS and the Provider Healthcare Portal
Coming Enhancements for IHCP Providers
Sara Rogers / February 18, 2016


Coming Soon: New Provider Interface
Indiana Health Coverage Programs (IHCP) will transition to a new system
CoreMMIS replaces IndianaAIM
Provider Healthcare Portal replaces Web interChange


Administrative Functions Will Be Easier on the Provider Healthcare Portal

Register for the Portal online
  • Must be enrolled as an IHCP provider first
  • Register online through the Portal
  • Authorize staff as “delegates” to perform functions on behalf of the provider
  • Set permission levels for delegates

Improved workflow for delegates

  • Delegates authorized by multiple providers at multiple locations can use the Switch Provider feature to quickly and efficiently select the appropriate provider and location

Enroll as an IHCP provider and manage provider profile online

  • Enroll as an IHCP provider with the ability to start, save, and resume enrollment
  • Add new service locations, phone #s, banking changes
  • Enroll new rendering providers
  • Revalidate enrollment

Send and receive secure correspondence

  • Communicate with the Portal support team
  • Receive secure responses to inquiries

Enhanced Operational Features Available on the Provider Healthcare Portal

View comprehensive member information with the Member Focused Viewing function
  • Member Focused Viewing function provides links to detailed member information:
  • View demographic Information
  • Verify eligibility and coverage details
  • See claims history
  • View approved prior authorizations
Improved prior authorization management
  • View up to 5 prior authorization requests and up to 20 active authorizations
  • Request new prior authorization for a member, with less data required
  • Add electronic attachments and notes to prior authorizations
Add electronic attachments to claims; view Remittance Advice history
  • Submit new claims
  • View 5 most recent claims submitted for a member
  • Attach up to 5 documents (5MB in total size) with a claim
  • No limit to viewable Remittance Advice (RA) history

Enhanced Operational Features Available on the Provider Healthcare Portal, cont.

View member coverage limitations
  • When members use benefits with dollar-based or service-based coverage limitations, the limitations appear on a “Limit Details” panel in the Provider Healthcare Portal.
  • View benefit limit and amount remaining for the member, based on processed claims
Create a “Favorite Provider” list
  • Use “Favorite Provider” list to make referrals to other providers and specialists

Registration on the Provider Healthcare Portal

All IHCP providers will need to register on the Provider Healthcare Portal to do business with the IHCP.

Providers are encouraged to stay informed about key dates and preparation information.
  • Watch for announced dates of web-based training courses
  • Provider Healthcare Portal Overview – AVAILABLE NOW
  • Review CoreMMIS bulletins
  • Sign up for the indianamedicaid.com email notifications

Prepare Now For Provider Healthcare Portal Training
  • Identify staff who need training and inform them of training options and availability
  • Ensure that staff taking web-based training have a computer with Internet access
  • Find available training courses on indianamedicaid.com under the “Provider Education” tab
  • Sign up to receive bulletins/banners

New and Updated Training at indianamedicaid.com

Providers will need training on how to use the Portal to conduct business with the IHCP. Portal training will be available and will be presented in three formats: web-based training, virtual training, in-person training.
  • Most training will be offered as web-based sessions. The Portal Overview course is available now on indianamedicaid.com; and others will be added this year. You and your staff can take the courses when it’s most convenient for you.   
  • Virtual training will combine the convenience of web-based courses with a supplemental live narrative audio component, similar to an in-person training course.
  • Your local Provider Relations field consultant will be available to provide in-person training through various workshops in the coming months.

Pilot Testing

Pilot testing serves as a way for the IHCP to validate different components of the new system, verifying that the components work as intended and meet IHCP requirements.

Providers have been engaged in pilot testing the system.

What areas of CoreMMIS did providers test?
  • Registration on the new Provider Healthcare Portal
  • Claims submission
  • Prior Authorization submissions
  • Member eligibility inquiries
Thank you

For additional questions about CoreMMIS and the Provider Healthcare Portal, email incoremmis2015im@hp.com.

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