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Mar 27, 2024 · The Indiana Health Coverage Programs (IHCP) provides reimbursement for emergency services provided to IHCP members. Guidelines for these services are subject to the member’s program enrollment. Providers should bill for emergency services using the appropriate type of claim for their provider type and specialty.
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of that care. IHCP providers are not allowed to bill members for covered services and are responsible for billing correctly. Coverage for Package E members is limited to only emergency services. For these members, services must meet the emergency criteria noted in this bulletin to be eligible for IHCP reimbursement.
Effective for dates of service (DOS) on or after March 1, 2020, through the duration of the public health emergency for coronavirus disease 2019 (COVID-19), the Indiana Health Coverage Programs (IHCP) will reimburse Emergency Medical Services (EMS) providers for appropriate and medically necessary care billed under Healthcare Common Procedure ...
ALS and BLS definitions: ALS – The IHCP provides reimbursement for medically necessary emergency and nonemergency ALS ambulance services when the level of service rendered meets the Indiana Emergency Medical Services Commission (EMSC) definition of ALS in Indiana Code IC 16-18-2-7 and in Indiana Administrative Code 836 IAC 1-1-1, which ...
IHCP Provider Reference Modules. The Indiana Health Coverage Programs (IHCP) provider reference modules are the primary reference for billing and reimbursement guidance for providers conducting business with the IHCP. Modules include instructions for submitting IHCP claims and prior authorization (PA) requests, as well as other related topics.
Apr 12, 2019 · Emergency Services module, is available below for reference. The IHCP does not reimburse hospitals for nonemergency services rendered in emergency room settings. Hospitals are reimbursed for screenings that are necessary to determine whether the member has an emergency condition. Revenue code 451 – EMTALA – Emergency Medical Screening Service
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IHCP provides billing guidance to EMS provider agencies for naloxone administration. Effective July 1, 2020, the Indiana Health Coverage Programs (IHCP) will begin reimbursing Emergency Medical Services (EMS) provider agencies for administering naloxone (see IHCP Bulletin BT202058). This policy applies to both fee-for-service (FFS) and managed ...
