Provider Manuals and Quick Reference Guide

• MHS Provider Manual (PDF) effective January 1, 2013
• Indiana Medicaid Provider Manual Page
• MHS Provider Quick Reference Guide (PDF) effective March 1, 2013

Pharmacy

• IHCP Preferred Drug List effective December 31, 2009

Prior Authorization

• Prior Authorization Code Updates, Effective May 1, 2013
• Prior Authorization Code Updates, Effective February 1, 2012 (PDF)
• Injection Code Requiring Prior Authorization for MHS

Pay for Performance and Scorecards

• EPSDT Billing Points Guide (PDF)
• MHS Provider Scorecard FAQ (PDF)
• What We Look for in a Medical Record (PDF)
• Pre-Payment Review Guide (PDF)
• How to Interpret Your Pay for Performance (PDF)

Claims/Billing

• 5010 837P/I Companion Guide and Addendum B (PDF)
• 276-277-Companion-Guide (PDF)
• 270-271 Companion Guide (PDF)
• HIPAA ver. 5010 Implementation FAQ (PDF)
• MHS Denial Codes (PDF) updated October 2012
• EDI COB Mapping Guide (PDF)
• Reject Reason Codes and Descriptions (PDF)
• Edifecs Ramp Manager Tutorial – EDI X12 Testing Center (PDF)

POWER Account

• POWER Account Billing Guide (PDF)

Other

• Pre-Payment Review Guide (PDF)
• FQHC and RHC Billing FAQ (PDF)

Member Management, Member Benefits and Services

Pregnancy Member Management

• MHS Presumptive Eligibility FAQ (PDF)
• MHS Notification of Pregnancy FAQ (PDF)
• Next steps for a Pregnant HIP Member FAQ (PDF)
• 40 Weeks Provider Toolkit (PDF)
• Enhanced Services for Pregnant Members (PDF)

Plans, Services and Programs

• Healthy Indiana Plan FAQ (PDF)
• MHS Right Choices Program FAQ (PDF)

MHS Secure Provider Portal Training / Tutorials

• Provider Secure Portal Guide (PDF)
• MHS Secure Provider Portal New Account Registration Help – For new accounts starting March 27, 2013

The following tutorials may not be accurate step-per-step after March 27, 2013:

• How to Submit Batch Claims on the MHS Provider Portal (PDF)
• How to Use the Adjust Claims Feature on the MHS Provider Portal (PDF)

Workshop and Other Presentations

• Second Quarter 2013 HP Presentation (PDF)
• First Quarter 2013 HP Presentation (PDF)
• Burmese Member Training (PDF) – This training slide show includes information from all Managed Care Entities.
• Specialists’ Orientation for MHS (PDF)

About MHS and Other Reference Materials

• MHS’ Health Plan Annual Report Card 2011 (PDF)
• 2012 QI / UM Program Description (PDF)
• Culturally & Linguistically Appropriate Services Brochure (PDF)
• Medical Record Documentation Audit Tool (PDF)

Indiana Medicaid Bulletins and FAQs

• BT200948 Pharmacy Benefit Consolidation Effective December 31, 2009
• Indiana Medicaid Notification of Pregnancy FAQs and Bulletins
• Tobacco Cessation Counseling Reimbursement Bulletin

HEDIS

• 2012 HEDIS Measures (PDF)
• 2013 HEDIS Measures (PDF)

Having trouble finding what you need in a PDF? Hit Ctrl+F or go to Edit > Find, type in the term you are looking for, and press enter. Find will take you to the first use of that term. Each time you press enter, find will take you to the next occurrence of the term until you reach the end of the document.

If you would like any of these guides in print, please contact Provider Services at (877) 647-4848.