[Indiana] Update to High Dollar Claims

Immediate: Billing team must obtain the Itemized Bill Cover Sheet from CareSource.com (Forms or Claims pages) and integrate into submission workflow. For all claims with billed charges over $500,000, claims identified for itemized bill review, DRG/outlier claims, outpatient grouper pricing, or percent-of-charge contracts over $25,000: (1) Complete Section 1 of the cover sheet at time of submission; (2) Type the form for clarity; (3) Submit via email (ClaimsItemizedBill@CareSource.com) or fax (1-937-396-3173 or toll-free 1-844-794-1579); (4) Keep file size under 12 MB, split large files across multiple submissions and mark Section 2 accordingly; (5) Use cover sheet for both new and corrected claims. For vendor-submitted requests (Optum, 6 Degrees Health, etc.), submit itemized bills directly to the vendor per their instructions. Failure to include required documentation will result in claim processing delays or denials. Contact Indiana Medicaid Provider Services at 1-844-607-2831 (M-F, 8am-8pm ET/7am-7pm CT) or Indiana Marketplace Provider Services at 1-833-230-2101 (M-F, 8am-6pm ET/7am-5pm CT) with questions.