MedicaidAdministrativeMedium impact
BT2025125: Electronic claim submission process updated for dually eligible members with no or exhausted Part A benefits
Indiana Medicaid (IHCP)·IN·Claims & Billing
Effective date
May 28, 2025
We identified it
Jun 18, 2026
Summary
Indiana Medicaid updated electronic claim submission requirements for dually eligible members with no or exhausted Medicare Part A benefits, effective May 28, 2025. Specific adjustment reason codes, claim filing indicators, and Medicare paid amounts must now be included when submitting inpatient acute care claims electronically.
Action Required
Immediately: Billing team must update electronic claim submission procedures for Indiana Medicaid dually eligible members with no/exhausted Part A benefits. Configure billing system to include ARC 119, appropriate claim filing indicators (MA/MB), and correct Medicare paid amounts for inpatient acute care services. Update 837I transaction templates to include required Other Payer Name loops for Part A and Part B when applicable. Train staff on new IHCP Portal submission requirements including different Carrier Names and IDs for Medicare Parts A and B.