MedicaidDocumentationHigh impact
BT202586: Documentation requirements clarified for claims billed to Medicaid for dually eligible members
Indiana Medicaid (IHCP)·IN·Provider Bulletin
Effective date
Jun 19, 2025
We identified it
Jun 18, 2026
Summary
Indiana Medicaid now requires exact data matching between claims and Medicare EOB/EOMB for dually eligible members. Claims for Medicare-denied services must include the detailed denial documentation or face automatic rejection with EOB code 2502.
Action Required
Immediately: Billing team must attach Medicare or Medicare Advantage denial EOB/EOMB documentation when submitting claims to Indiana Medicaid for dually eligible members. Ensure all claim data exactly matches the Medicare EOB information. Update billing workflow to verify documentation is included before submission. Claims without required documentation will be denied with EOB code 2502.