MedicaidAdministrativeMedium impact
BT202387: IHCP changes submission requirements for FFS claim administrative review process
Indiana Medicaid (IHCP)·IN·Claims & Billing
Effective date
Jul 27, 2023
We identified it
Jun 19, 2026
Summary
Indiana Medicaid (IHCP) has simplified the documentation requirements for requesting administrative reviews of denied fee-for-service claims. Previously providers had to submit claim forms, original claims, remittance advice, and all attachments - now they only need to submit pertinent documentation supporting reconsideration, though they're encouraged to include a completed claim form to expedite processing.
Action Required
Immediately: Billing team should update administrative review request procedures for Indiana Medicaid claims. When filing claim reviews, submit only pertinent supporting documentation (medical records, TPL forms, filing limit docs as needed). Include a completed paper claim form to expedite processing if the review is approved. Ensure all requests include Claim ID, previous filing IDs, and detailed reason for disagreement. Submit via IHCP Portal or mail within 60 days of claim denial notification.