The Children's Special Health Care Services (CSHCS) Division at the Indiana Department of Health (IDOH) is excited to announce the supplemental
coverage program will be transitioning to paperless claim processing effective July 1, 2021. All participating providers who currently submit paper
claims MUST utilize the new Provider Portal to submit claims. This does not impact or replace those that currently submit claims electronically
through a clearinghouse. That process will continue unchanged. The program accepts all HIPAA transactions according to HIPAA regulations.
The CSHCS program will provide technical assistance and training material for processing applications to the Provider Portal.
The Provider Portal User Manual can be found by clicking WEB-Enabled Direct Data Entry User Manual.
We are committed to conducting transactions with the health care provider community as efficiently as possible.
The Provider Portal is a significant step in modernizing our processes. Should you have any questions or concerns,
please feel free to go to the CSHCS website https://www.in.gov/health/cshcs/,
or contact the Indiana Department of Health Electronic Data Interchange (EDI) helpdesk by phone at 1-317-233-9803 (local) or 1-800-475-1355,
option 5, option 1 or email [email protected].
The Provider Portal will allow providers to check participant enrollment and claim status/history and will also enable providers to print an EOP/Remittance Advice. To enroll, please click WEB Portal Enrollment and Change Form.
ATTENTION: YOU MUST HAVE A PRIOR AUTHORIZATION (PA) ON FILE BEFORE RENDERING SERVICES TO CSHCS PARTICIPANTS AND SUBMITTING CLAIMS. FAILURE TO HAVE A PA ON FILE WILL RESULT IN CLAIMS BEING DENIED. THE SERVICE FACILITY LOCATION ON THE CLAIM MUST MATCH THE ADDRESS ON THE PA OR CLAIMS WILL BE DENIED.
Effective September 21, 2020, all Schedule II drugs will require a PA in order to remain compliant with the National Council for Prescription Drug Programs (NCPDP) guidelines regarding Schedule II drugs.
Effective on 01/01/2022, All Services with a cost greater than or equal to $500.00 will require a PA. Please contact the CSHCS Medical Eligibility/PA Section at 1-800-475-1355 and select option #3.