Transcription of Claim Submission and Processing
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Claim Submission and Processing
INDIANA HEALTH COVERAGE PROGRAMS PR O V I D E R RE F E R E N C E MO D U L E Claim Submission and Processing L I B R A R Y R E F E R E N C E N U M B E R : P R O M O D 0 0 0 0 4 P U B L I S H E D : M A R C H 2 3 , 2 0 2 1 P O L I C I E S A N D P R O C E D U R E S A S O F J U L Y 1 , 2 0 2 0 V E R S I O N : 5 . 0 Copyright 2021 Gainwell Technologies. All rights reserved. Library Reference Number: PROMOD00004 iii Published: March 23, 2021 Policies and procedures as of July 1, 2020 Version: Revision History Version Date Reason for Revisions Completed By Policies and procedures as of October 1, 2015 Published: February 25, 2016 New document FSSA and HPE Policies and procedures as of July 1, 2016 Published: December 15, 2016 Scheduled update FSSA and HPE Policies and procedures as of July 1, 2016 (CoreMMIS updates as of February 13, 2017) Published: May 23, 2017 CoreMMIS update FSSA and HPE Policies and procedures as of July 1, 2017 Published: January 23, 2018 Scheduled update: FSSA and DXC Policies and procedures as of April 1, 2018 Published: September 6, 2018 Scheduled
• Updated Table 4 –UB-04 Claim Form Fields • Updated the Portal Institutional Claim Submission Process subsections •Added notes about changes to provider types/specialties in to Table 5 – Types of Services Billed on Professional Claims •Updated Table 6 –CMS-1500, Version 02/12, Claim Form Fields • Updated the Portal Professional ...
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