MedicaidAdministrativeMedium impact
BT2023131: OMPP clarifies request for HIP MCEs to reprocess denied Medicare coinsurance claims
Indiana Medicaid (IHCP)·IN·Managed Care
Effective date
Oct 5, 2023
We identified it
Jun 19, 2026
Summary
Indiana's Office of Medicaid Policy and Planning is requiring HIP managed care entities to reprocess previously denied Medicare coinsurance and deductible claims for dual-eligible members with dates of service from March 1, 2020 onward. Providers must resubmit corrected claims with matching procedure codes within 90 days, with timely filing requirements waived.
Action Required
By January 3, 2024: Billing team must identify and resubmit corrected claims for HIP dual-eligible members with DOS on or after March 1, 2020 where procedure codes did not match Medicare remittance. Follow each MCE's guidelines for corrected claim submission and attach this bulletin for timely filing waiver. Review all denied Medicare coinsurance and deductible claims for these members.