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Experience. Integrity. Advocacy.

When Is a Due Date Not Really a Due Date? Reviewing Indiana Medicaid Revalidations

medicaid revalidations

Indiana Medicaid recently published a new list of providers who must revalidate their enrollment. The list, available for download from the Indiana Medicaid website, includes providers with due dates over the next several months, through December 2018 according to the file name, though many providers also are listed with dates beyond December 2018.

According to Indiana Health Coverage Programs (IHCP), when it is time to revalidate their enrollment, providers will receive notification letters at 90 days and 60 days in advance of the revalidation due date. Notices are sent to the mail-to address indicated on the provider’s service location profile and also included as a reminder on the home page of their Provider Account on IHCP’s Provider Healthcare Portal. Providers with multiple service locations must revalidate the enrollment of each service location and will receive notification for each separately.

Timing Is Everything

Timing is everything when it comes to revalidating enrollment. Providers are not allowed to revalidate until they receive their notification letter, but providers who fail to revalidate in a timely manner will be disenrolled from participation in the IHCP.

Also, according to Denise O’Brien, CIPROMS Director of Provider Enrollment, the due date isn’t really the due date.

“IHCP really wants the revalidation 30 days prior to the due date posted so they can process it,” O’Brien said. “So instead of a full 90 days you really only have 60 days to complete the revalidation and send it to IHCP.”

As a result, providers should ensure their mail-to address is up-to-date on the Provider Healthcare Portal so they receive the revalidation notification letters in a timely manner. Additionally, providers should frequently check the list of Indiana Medicaid revalidation due dates to ensure they haven’t missed receiving their notification letters. If the due date indicated on the published list is within 90 days, providers should assume a letter has been mailed and proceed with revalidating their enrollment.

Providers who find themselves disenrolled from Medicaid because of a failure to revalidate in a timely manner will need to re-enroll with the IHCP, which could result in a gap in eligibility.

Revalidation Is Easy

The good news, though, is that revalidation is easy, O’Brien said. Providers can revalidate by signing in to their Provider Account on IHCP’s Provider Healthcare Portal. By using the portal, a provider’s information will pre-populate into the revalidation form, and online help is available to walk providers through the process. Also, required documentation can be uploaded and submitted electronically. (See what documentation is required by reviewing the IHCP Provider Enrollment Type and Specialty Matrix.)

Providers who wish to revalidate on paper must use the appropriate IHCP provider packet—the same as is required at initial enrollment. There is not a separate revalidation form, so providers will need to indicate “Revalidate Enrollment” in field 1 on Schedule A under Type of Request.

Only certain types of providers must pay a revalidation fee. Review the IHCP Provider Enrollment Risk Category and Application Fee Matrix to determine whether an application fee is required by your provider type, along with additional screening criteria that may apply to your provider specialty during revalidation.

Find Out More

Medicaid revalidation is mandated for most healthcare providers at least every five years by the Centers for Medicare and Medicaid Services (CMS). Durable medical equipment (DME) and home medical equipment (HME) providers, including pharmacy providers with DME or HME specialty enrollments, must revalidate enrollment at least every three years. For more information about provider enrollment revalidation, see the Provider Enrollment provider reference module or visit the Provider Enrollment Revalidation page on the Indiana Medicaid website.

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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