REQUIREMENTS:
Immediate Actions (All billing staff):
1. Identify all affected locations: Determine whether your practice or any patient members reside in the 21 designated Indiana counties (Carroll, Cass, Dearborn, Delaware, Fayette, Fountain, Franklin, Hamilton, Henry, Lake, LaPorte, Madison, Marion, Marshall, Morgan, Porter, Pulaski, Putnam, Starke, Tipton, Warren, Wayne).
2. Update claim submission procedures to flag disaster-related claims with a notation identifying the member/provider location as disaster-impacted.
By November 30, 2026 (Deadline):
1. Billing team must accept and process retroactive prior authorization requests for services rendered during the August 11-present disaster period, provided they are submitted within 60 calendar days of service date and include:
- Medical necessity documentation
- Attestation describing how the flooding affected member access to care, provider's ability to obtain prior auth, or other relevant circumstances
- DO NOT process retrospective auth requests submitted after November 30, 2026.
2. For replacement DME/HME/medical supplies claims:
- Accept expedited authorization requests
- Require documentation of: member's need for replacement, relationship between loss and flooding event, date equipment was provided
- Case-by-case review permitted for replacement limitation overrides when disaster causation is documented.
3. For timely filing exceptions:
- Billing team must add claim note: "Waive timely filing due to natural disaster"
- Attach documentation supporting nature and duration of disruption
- Submit to IHCP for case-by-case review; timely filing relief is NOT automatic.
4. For services from alternate locations:
- Continue using standard billing procedures
- Ensure compliance with all licensure, certification, and health/safety requirements
- Maintain documentation of disaster-related operational disruptions (office closures, IT interruptions, staff displacement, member displacement, etc.).
5. Contact MCOs directly for managed care member claims; contact IHCP Customer Assistance Unit at 800-457-4584 for fee-for-service issues.
Consequences: Claims submitted without sufficient supporting documentation will be subject to standard authorization requirements and may be denied. Retrospective authorization requests received after November 30, 2026, will not be eligible for disaster flexibilities.