Network and Provider Relations Update

InteCare re-instituted regular meetings of the Inte- Care Medicaid Network Advisory Board (IMNPAB) this past summer, in order to have increased communication and keep the InteCare Provider Network (CMHC’s) up to date on the Hoosier Healthwise, Healthy Indiana and Care Select Programs. These meetings are a forum for InteCare to relay important information regarding Managed Medicaid and Network updates, as well as discuss and help assist the CMHC Network providers with addressing any system issues that they may be confronting.

One area that continues to present problems is claims adjudication and payment. In the fall IMNPAB meeting there was significant discussion surrounding ongoing claims issues, several stemming back from when the Managed Medicaid program was initiated in January 2007. The outcome of this discussion was the recommendation from Board members that InteCare convene a “Claims Task Force” to review each of the identified issues in depth, gather more information, research issues as needed and formulate recommendations to discuss with the MCOs/MBHOs and OMPP for resolution.

InteCare followed this suggestion and created and facilitated the “Claims Task Force”. The Task Force is composed of individuals from the CMHCs who manage claims/billing issues regularly and are experts in this area. The participation and feedback from the Task Force has been excellent with very productive outcomes. The Task Force has met twice as a group and reviewed several identified issues that appear to be chronic and the most problematic for providers. The Task Force researched, discussed and summarized these issues into one document and listed their feedback and recommendations for further discussion with the MCOs/MBHOS and OMPP. In late February members of the Task Force met with representatives from Anthem, Magellan, MDwise, MHS, Cenpatico and OMPP. The goal of the meeting was to partner with the MCOs/MBHOs and OMPP to try to resolve these ongoing claims issues and find resolution. The turnout for this meeting was good and the discussion was valuable and constructive for everyone. The next step entails InteCare coordinating actions items of the parties and then following up in hopes of making some significant changes and a positive impact regarding these issues.

Quick Note to Providers who are in their own practice or connected to a small group practice:

If you changed your practice location or added additional licensed providers at your practice please contact InteCare as soon as possible so that we can make the necessary changes to the database. If you have added another provider at your practice or a currently contracted provider has left, please contact our Credentialing Department to assist you as soon as possible. It is very important to keep your information accurate and up to date. To share this information please contact Carol Gorbett , Credentialing Specialist at 317.237.5776 (cgorbett@intecare.org) or Stacy Veach, Clinical and Provider Relations Director at 317.522.2764 (sveach@intecare.org) or Julie Maxwell-Coker, Credentialing Manager at 317.829.5759 (jmaxwellcoker@intecare.org).