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  • In Ihcp Mce Hospital/ancillary Provider Enrollment And Credentialing Form 2024

Get In Ihcp Mce Hospital/ancillary Provider Enrollment And Credentialing Form 2024-2025

IHCP MCE HOSPITAL/ANCILLARY PROVIDER ENROLLMENT AND CREDENTIALING FORM This form is used to enroll participating facilities such as hospitals, home health agencies, and other nonpractitioner providers.

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Log into your Member Portal Account or create a New Account. ... Once on the Member Homepage, click on Change Primary Provider. Once you click on Change Primary Provider, select your network from Hoosier Healthwise, Healthy Indiana Plan (HIP) or Hoosier Care Connect. Review your choice of PMP by clicking Select.

Provider Enrollment Inquiries If you have questions about IHCP provider enrollment, enrollment status or provider profile updates, call Customer Assistance at 800-457-4584 and select option 2, and then option 1 to check provider enrollment status or option 3 to update provider enrollment information.

Contacts for Members Not Enrolled in a Health Plan: Traditional Medicaid (Not enrolled in a health plan) Member Services800-457-4584 Pharmacy Services 855-577-6317

Set-up may take 45 – 60 days after we receive your submission. You must be enrolled with Indiana Medicaid and have an Indiana Medicaid provider number. Once the form is completed and you have uploaded the W9 Form, click Submit and this will be routed to the MHS Enrollment Team.

If you're enrolled in a health plan through Medicaid or CHIP, contact the member services phone number on your eligibility letter or the back of your enrollment card. This information should also be on the websites of your health plan or Medicaid or CHIP agency.

Required Information: Provider credentialing focuses on the provider's education, training, and licensure. Provider enrollment requires most of this information in addition to information regarding their employment terms and practice location.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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