December 2016 Updates: Important Info for Providers
CoreMMIS Update – Start Date Delayed
IHCP is delaying the December 5, 2016, implementation of the new CoreMMIS system which will replace the current Web interChange portal. The delay in implementation is necessary for additional readiness testing. All transition activities are suspended and regular processes are in effect. Despite the delay, providers should continue to register for the Provider Healthcare Portal and make preparations for the transition, including participating in training activities to learning how to use the new portal and its features. No new date has been announced, but IHCP and MHS will continue to keep you updated on CoreMMIS implementation.
What is CoreMMIS?
CoreMMIS will replace Web interchange, which is currently used to look up member eligibility including restrictions, managed care affiliations, and co-pays, provider enrollment information, and the preferred drug list. The new portal, known as CoreMMIS, will include many new features including the ability to perform online provider enrollment transactions. These new online transactions will include first-time provider enrollment, enrolling a new service location and enrollment revalidation.
Pharmacy Benefit Manager Changes Effective 1/1/2017
Effective January 1, 2017, MHS will manage pharmacy benefits for all members enrolled in Hoosier Healthwise and HIP Maternity. Members will receive a new ID card in the mail beginning in December. The new card will include additional information needed for pharmacies to process prescriptions. You can find more information and the Hoosier Healthwise Preferred Drug List (PDL) at mhsindiana.com.
In addition on January 1, 2017, Walgreens will no longer be in the MHS Pharmacy Network for Hoosier Healthwise, Healthy Indiana Plan (HIP) and Hoosier Care Connect members. Most other retail pharmacies continue to be in the pharmacy network, including CVS, Walmart, Meijer and Kroger pharmacies. Members are being notified of this change and asked to transfer their prescriptions or have a new prescription written or sent to their new network pharmacy of choice by January 1, 2017.
Dental Benefit Manager Changes Effective 1/1/2017
Starting January 1, 2017, MHS will begin administering dental benefits through Envolve Dental for Hoosier Healthwise (HHW), in addition to HIP and Hoosier Care Connect (HCC). Envolve Dental will honor authorizations approved by Indiana Fee-for Service Medicaid prior to January 1, 2017 with dates of service between January 1, 2017 and March 31, 2017, or until the authorization expiration date. Include the authorization approval letter when submitting claims to Envolve Dental. Please register today on the Envolve Dental Provider Web Portal by contacting their Provider Services team at 1-855-609-5157 or at firstname.lastname@example.org. The portal is user-friendly, quick, and accessible at pwp.dentalhw.com.