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Clarification on Eligibility Reporting in CoreMMIS

Clarification on Eligibility Reporting in CoreMMIS
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IHCP clarifies how eligibility and coverage are reported in CoreMMIS

The Indiana Health Coverage Programs (IHCP) has received a number of inquiries from providers regarding the eligibility and coverage information that CoreMMIS conveys through the IHCP Eligibility Verification System (EVS) options – the Provider Healthcare Portal (Portal), the Interactive Voice Response (IVR) system, and electronic data interchange (EDI) eligibility transactions. Eligibility and coverage information is reported differently in CoreMMIS than it was in IndianaAIM.

Eligibility verification in the Portal is a two-step process

Verifying eligibility in the Portal requires a simple two-step process. First, the system verifies the member’s active coverage for one or more benefit plans. Second, the system provides details and limitations about the member’s coverage that providers need to know. The steps describing this process for verifying eligibility using the Portal are available in IHCP Bulletin BT201728.

The bulletin is available online at http://provider.indianamedicaid.com/ihcp/Bulletins/BT201728.pdf.

 

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