Indiana Health Coverage Programs

EDI Solutions

The following links are designed to relay important information to all providers and software developers who communicate via Electronic Data Interchange (EDI) format and Direct Data Entry (DDE).

The Providers links are intended for IHCP Providers. The EDI Vendors links are addressed to Clearinghouses, Billing Services, Managed Care Organizations (MCO), Valued Added Network (VAN), and Software Developers. Helpful Hints are directed to both Providers and EDI Vendors.

Information about the submission of National Provider Identifier (NPI) can be found in the IHCP Companion Guides, the What's New for Providers document, and the What's New for Vendors document.

For Providers:
What's New for Providers	IHCP updates regarding batch and interactive submission.
Provider EDI Implementation Procedures	Step by step procedures for becoming a trading partner with the IHCP.
IHCP Trading Partner Profile	Form required for trading partner set up.
IHCP Trading Partner Agreement	Agreement required for trading partner set up.
IHCP Approved Software Developers	Contact list of all approved software vendors and clearinghouses.
Web interChange	Alternative means for IHCP providers to perform direct data entry (DDE) functions.
Paper to Electronic Map for NPI Fields	Tables listing NPI-related fields on paper claim and how they relate to X12 fields for Indiana Medicaid claims processing.

For EDI Vendors:
What's New for EDI Vendors	Information about upcoming IHCP system updates, release dates, internal and external impacts, and pre-release Companion Guides identifying these modifications, known issues, corrections, and common compliance errors.
Software Testing Procedures	Step by step procedures for EDI vendors who have not yet been approved by the IHCP.
IHCP Companion Guides	Production versions of the Companion Guides.
EDI Vendor Testing Timeline	Timeline allowed for EDI vendors to make system modification for upcoming enhancements.
IHCP Pre-Release Companion Guides	Pre-Release versions of the Companion Guides.
Sybase Translator Information	Production version of the IHCP translator, Sybase product components and common compliance errors.
Paper to Electronic Map for NPI Fields	Tables listing NPI-related fields on paper claim and how they relate to X12 fields for Indiana Medicaid claims processing.

Helpful Hints:
Common Compliance Errors	Most common reasons why transactions are failing compliance and how to correct.
997 Functional Acknowledgement	Information on how to read a 997.
Frequently Asked Questions (FAQs)	Answers to the most frequently asked HIPAA / X12 format questions.
837 Billing of Crossover Claims Directly to the IHCP	Contains instructions for the billing of claims to the IHCP for dually eligible members that are initiated by the provider.
837 Billing of TPL Claims	Contains instructions for the billing of claims to the IHCP with Third Party Liability (TPL) coverage.