The IHCP will implement an electronic visit verification (EVV) system for federally required provider documentation of designated personal care and home health services. The IHCP is interested in hearing from you if you have input or need assistance. The California Dental Association maintains an online directory that can help you find a dentist in your area. Defines your rights over your health information. Both types of dispensers must by registered by the Board of Optometry. See Update Your Provider Profile on this website for more details. Psychologists work in hospitals, clinics, counseling centers, or private practice. Be sure to ask whether they will accept your insurance plan. Enroll as a provider with the IHCP to bring critical medical care to eligible Hoosier children and adults. Board of Vocational Nursing and Psychiatric Technicians 916.561.8200, Physician assistants Todays consumers have a wide range of choices in healthcare services, from traditional medical care to practices such as naturopathic and acupuncture. The IHCP reimburses for hospice services in a hospice facility, in a nursing facility, and in a private home. Visit our Frequently Asked Questions to learn more about the states we serve, becoming a TRICARE provider, adding providers to an existing practice, authorizations, and claims.. Join the West Region Network. IHCP providers should verify enrollment of the ordering, prescribing or referring (OPR) provider before services or supplies are rendered. California's requirements for home health care providers can be found at Home Care Services Bureau (HCSB). Substance Use Disorder (SUD)/Serious Mental Illness (SMI) Treatment. Misinformation like that can cause medical personnel to give you treatment or medications which could cause you serious harm. They also administer medications ordered by a physician, dentist, or other authorized healthcare provider. The Blue Cross name and symbol are registered marks of the Blue Cross Association. The Indiana Health Coverage Programs (IHCP) has a specific process for members, providers, or other interested parties who would like to submit requests for policy consideration. 866.503.3221 916.574.7720, Registered nurses Board of Registered Nursing NPI applications can be completed and submitted online. Please note Speech-Language Pathology and (888) 615-0016. Hoosier Care Connect is a health care program for individuals who are aged 65 years and older, blind, or disabled and who are also not eligible for Medicare. Any final adverse action documentation from legal cases against you or the practice you work for. The Portal will guide you through enrollment transactions based on your provider classification, as well as your provider type and specialty. Accessibility 2 Step 2: Complete the Medicare Enrollment Application Our resources for providers explain important guidelines such as the difference between emergency and non-emergency medical transportation, accepted types of transportation, the types of transportation service delivery systems, and driver and vehicle acceptance criteria. Osteopathic Medical Board of California The Healthy Indiana Plan is a health-insurance program for qualified adults ages 19-64. Anthem uses the Council for Affordable Quality Healthcare (CAQH) ProView application for credentialing. Providers interested in becoming qualified providers (QPs) for presumptive eligibility (PE) must complete an application through the IHCP Portal and contact IHCP Provider Relations to arrange training. The email notifications are used to send notices to subscribers on behalf of the IHCP. Do not sell or share my personal information. Contact the specific licensing entity for more information. Hoosier Care Connect is a health care program for individuals who are aged 65 years and older, blind, or disabled and who are also not eligible for Medicare. FSSA updates. Pharmacists 916.263.1978, Dentists The IHCP provides pregnant women and their babies with critical prenatal care and continued care for children throughout their developmental years. Find ratings and more information at www.calqualitycare.org. The IHCP provider enrollment instructions and processes are outlinedon these web pages. The Indiana Health Coverage Programs (IHCP) has a specific process for members, providers, or other interested parties who would like to submit requests for policy consideration. Once you have some names, call the doctors offices and ask if they are accepting new patients. Home Health and Hospice providers will need to complete additional forms and documentation for vehicles and other items. Dentists diagnose and treat diseases, injuries, and malformations of the teeth, jaw, and mouth. Thanks to all authors for creating a page that has been read 32,206 times. If you are part of a group practice that is contracted with Optum/OHBS-CA, please consult with your group administrator regarding joining the network. Even if you dont choose the hospital yourself, you may wish to check on how the hospital is rated by the California HealthCare Foundation. A completed professional malpractice liability questionnaire, including an explanation of all claims, settlements and open cases. Providers who choose not to use the Portal must complete an Indiana Health Coverage Programs Enrollment and Profile Maintenance Packet (IHCP provider packet) to enroll, add a service location, report a change of ownership, revalidate, or update certain provider profile information. Providers interested in becoming qualified providers (QPs) for presumptive eligibility (PE) must complete an application through the IHCP Portal and contact IHCP Provider Relations to arrange training. Acupuncturists treat health conditions by stimulating acu-points on the body. Through programs such as Traditional Medicaid, the Healthy Indiana Plan (HIP), Hoosier Healthwise, and Hoosier Care Connect, the IHCP performs a vital public service, helping about one in seven Hoosiers stay healthy or start down the road to better health. Board of Vocational Nursing and Psychiatric Technicians Follow up on any item you dont recognize. -Date (s) of appointment (s) -Time & duration of each appointment. To be considered an independently practicing psychologist you must: An independently practicing psychologist in Medicare can provide only diagnostic testing services if a physician orders such testing. TDD/TTY: (202) 336-6123, Choosing a taxonomy code in applying for your National Provider Identifier: Guidance from the APA Practice Organization, Medicare Learning Network MLN Guided Pathways. You may not need every type of licensed health professional listed in this guide, but its important to know what they are and what they do. Note: If you are enrolling in the Indiana Health Coverage Programs (IHCP) as an ordering,prescribing or referring (OPR) provider or updating an OPR enrollment, this page does not apply. First, read the Explanation of Benefits statement you get from your health insurer. information. The law applies to certain healthcare providers such as doctors, dentists, chiropractors, and pharmacies. The Preadmission Screening and Resident Review process is a requirement in all IHCP-certified nursing facilities, prior to admission or when there is a significant change in the physical or mental condition of a resident. These provider education training links cover topics such as documentation requirements, billing guidelines, and other program integrity- and audit-related issues. Accessibility Current offerings are posted here. If your state isn't listed, check out bcbs.com to find coverage in your area. Respiratory Care Board of California No pending licensing issues, such as an unresolved accusation by a board issuing the applicable license to practice. California State Board of Pharmacy, www.pharmacy.ca.gov, (916) 574-7900. An osteopathic physician puts special emphasis on the role of the bones, muscles, and joints in the healthy functioning of the body. Occupational Therapy Physical therapists Ordering, Prescribing or Referring Providers. Medicare does not charge an application fee for psychologists to enroll. Copies of Clinical Laboratory Improvement Amendments and Federal Drug Administration certifications and approval documents for each location, provider, and supplier, including Drug Enforcement Administration numbers when necessary. The IHCP reimburses for long-term care services for members meeting level-of-care requirements. 916.928.8390, Pharmacists/pharmacy technicians Be responsible for rendering your own services, meaning you are not an employee of a physician, institution or agency. Board of Optometry, www.optometry.ca.gov, (916) 575-7170 or (866) 585-2666. Some audiologists also fit and sell hearing aids. Providers must be enrolled as MRT providers to be reimbursed for MRT services. 916.574.7830, Midwives When registering your email, check the category on the drop-down list to receive notices of Dentists can specialize in orthodontics, pediatric dentistry, or periodontics. We are happy to talk with you about joining the Anthem provider network if you have questions or are not yet ready to start the online application process. Thank you for your interest in caring for military service members, retirees and their families. Board of Behavioral Sciences, www.bbs.ca.gov, (916) 574-7830. Board of Optometry, www.optometry.ca.gov, (916) 575-7170 or (866) 585-2666. - Member's MRN. A wide range of information on healthcare professionals and institutions is available to help you make the best healthcare choices and decisions for yourself and your loved ones. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. 800.633.2322 View the publication online at www.psychology.ca.gov/forms_pubs/consumer_guide.pdf. That will help you monitor any unpaid medical bills that are falsely charged to you. HCBS programs are intended to assist a person to be as independent as possible and live in the least restrictive environment possible while maintaining safety in the home. This option is not available to provider types and specialties that are excluded from out-of-state enrollment. Educational psychologists work in schools or in private practice and provide educational assessment and counseling relating to academic ability, behavior, and other matters. Visit this page for information about upcoming webinars and recordings of past presentations. Family Member/Associate Transportation Providers. Here are some tips from the FTC. Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board, www.speechandhearing.ca.gov, (916) 263-2666. To inquire about participating, please email Anthem at the nearest regional health plan: Northern California: The resources for our providers may differ between states. The doctor who is treating you may decide which hospital is appropriate for your care. Medicaid has a 5 year revalidation requirement for Suppliers of Durable Medical Equipment and Supplies Fingerprinting for Medicaid "high" risk providers required as of July 1, 2018 Risk categories for Medicaid-only provider types may differ other provider types will have similar risk level as Medicare application process Board of Behavioral Sciences, www.bbs.ca.gov, (916) 574-7830. IHCP providers should verify enrollment of the ordering, prescribing or referring (OPR) provider before services or supplies are rendered. Find out more about the program enrollment process and requirements. The IHCP allows a family member or close associate of a Medicaid member to officially enroll as a driver, so the driver's mileage can be reimbursed. Your provider classification, type, and specialty will also determine the appropriate paper IHCP provider packet to use and the specific instructions for completing it. There are ways to spot medical identity theft early on. The resources for our providers may differ between states. What matters is that you have the appropriate clinical training and are licensed to provide direct services independently. In those cases, to admit patients, the physician without admitting privileges must use an admitting panel or provide evidence that there will be another Blue Shield network physician with admitting privileges who will admit the patient. Inside the packet, you'll find: Medi-Cal program information Your available plan options A plan comparison chart Form and phone number (to help you choose a plan) An individual applying to be a clinical psychologist in Medicare must agree to consult with their patients primary care or attending physician. A provider enrollment application must be submitted, either via the Portal or using the appropriate IHCP provider packet, for the following transactions: In addition, an IHCP provider packet may be required to update certain provider profile information for an existing IHCP provider. You can also visit. We value our partnership and appreciate the family-like relationship that you pass on to our members. 916.928.4785, Nurse practitioners Board of Optometry IHCP-enrolled providers interested in enrolling as a provider for Healthy Indiana Plan (HIP), Hoosier Healthwise, or Hoosier Care Connect members must apply directly to one or more of the managed care entities (MCEs). View IHCP announcements about upcoming events and other timely news items, and access communications published by IHCP's partnering managed care entities. This article has been viewed 32,206 times. Psychologists Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place. Home California State Board Include banking information as necessary if you have an agreement with a bank to cover pending Medicare payments. Entities of the California Department of Consumer Affairs license and regulate more than 19 different types of healthcare professionals, from doctors and nurses to hearing aid dispensers, psychologists, and others. Special prior authorization requirements apply for services rendered by IHCP providers with an out-of-state enrollment status. Board of Vocational Nursing and Psychiatric Technicians, www.bvnpt.ca.gov, (916) 263-7800. Current offerings are posted here. The 590 Program provides coverage for certain healthcare services provided to members who are residents of state-owned facilities. Board of Registered Nursing Providers must be enrolled as MRT providers to be reimbursed for MRT services. Doulas who wish to be reimbursed for services provided to Medi-Cal beneficiaries will need to enroll as providers. At least once a year, ask the health insurers youve been involved with for a list of the benefits they paid in your name. Electronic Data Interchange (EDI) Solutions. Find presentations from the most recent IHCP workshops and seminars are archived here. Self Empowerment Choosing a Mental Health Professional in California is a consumer publication from the Board of Behavioral Sciences. Another danger of medical ID theft, according to the Federal Trade Commission (FTC ), is that debt collectors could come after you for the scammers unpaid medical debts. This secure and private portal reduces the amount of paperwork you need to fill out to complete the credentialing process. The information that identifies and describes an enrolled IHCP provider is called a Provider Profile. Physician assistants work with supervising physicians to provide patient evaluation, education, and other healthcare services. Acupuncturists 866.543.1311, Clinical social workers Preadmission Screening and Resident Review (PASRR). View and search bulletins, banner pages and provider reference modules for information and updates on important topics including IHCP policies and procedures. To receive notices, you must subscribe. Individuals enrolled as independently practicing psychologists often hold terminal masters degrees. Medical Board of California Finally, make it a regular practice to check your credit reports. Enrollment transaction submissions are needed to enroll, add a service location, report a change of ownership, revalidate, or update provider profile information. There are approximately 182,000 MediCal providers who serve the medically necessary needs of the Medi-Cal population. Find the forms you need to serve members and transact business with the IHCP. A provider enrollment application must be submitted, either via the Portal or using the appropriate IHCP provider packet, for the following transactions: Enroll as an IHCP provider for the first time - When you enroll as a provider with the IHCP, you will need to enroll online through the Portal or complete and submit the appropriate IHCP . The California Department of Public Health has consumer information on nursing home residents rights, how to choose a nursing home, and other matters. Low-income individuals who don't qualify under another eligibility category may qualify for family planning services under the Family Planning Eligibility Program. Program for All-Inclusive Care to the Elderly (PACE). Under the IPA/medical group arrangements, operational functions are delegated, with Blue Shield Promise providing oversight. Following the procedures and using the correct terminology will speed your application process. Board of Psychology, www.psychology.ca.gov, (866) 503-3221 or (916) 574-7720. Dental Board of California, www.dbc.ca.gov,(916) 263-2300 or (877) 729-7789. This page offers quick access to the most commonly used provider portals for IHCP transactions, such as prior authorization, claim submissions and enrollment updates. Otherwise, you will need to sign a direct contract with Blue Shield. California Health and Safety Code 1367.63 requires health care service plans to cover reconstructive surgery. You can start an A clinical psychologist in Medicare is an individual who: Clinical psychologists can perform diagnostic psychological and neuropsychological tests without a physician or authorized non-physician practitioners order.
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