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  • Provider Claims Dispute Form - Mdwise - Mdwise

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Provider Claims Dispute Form Provider s Name: Date: Telephone Number: Fax Number: Member Name: Date of Service: RID #: MDwise Participating Provider: Yes No Service(s) Disputed: Describe disputed.

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Contact support

MDwise is Here to HelpMDwise is available by phone to help members and consumers understand the health plans and benefits we offer: For Hoosier Healthwise and Healthy Indiana Plan, MDwise customer service is available at 800.356.

The MDwise Excel Network delivery system will take over all business functions including management of the network, provider contracting, medical management, claims payments and other administrative functions for the 123,000 MDwise Hoosier Alliance membership and 1,200 providers previously served by Hoosier Alliance.

Who is MDwise? MDwise is an Indiana-based, nonprofit health plan. MDwise signs a contract with the State of Indiana to offer health coverage to Hoosier Healthwise members. MDwise provides the doctors and medical services to Hoosier Healthwise members who choose or are assigned to MDwise as their health plan.

Hoosier Healthwise is a health care program for children up to age 19 and pregnant women. ... Traditional Medicaid is a program created to provide health care coverage to individuals who are not enrolled in managed care.

The Healthy Indiana Plan (HIP) is the name of the State of Indiana's health insurance program. It is one of the Medicaid programs available to Indiana residents between 19 and 64 years old that are eligible. ... MDwise is called your health plan for the Healthy Indiana Plan.

The Healthy Indiana Plan (HIP) is a health insurance program for qualified adults. HIP is offered by the state of Indiana. The plan pays for medical costs for members and can include dental, vision and chiropractic.

Healthy Indiana Plan (HIP) members get a variety of health care benefits and services. You can see a doctor for preventive care visits. If you want help to quit smoking or to deal with drug/alcohol abuse, MDwise can help. We can also get you information about community services close to you.

MDwise is your local, Indiana-based nonprofit health care company. ... MDwise works with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health insurance programs.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232