Providers are always advised to verify eligibility before providing services to a Hoosier Healthwise (HHW) patient. There are two ways to find your drug within the formulary: Medical Condition Drugs in this formulary are grouped into categories depending on the type of medical conditions that Based on family income, children up to age 19 may be eligible for coverage. Hoosier Alliance pays Hoosier Healthwise claims for their members. MDwise is a not-for-profit corporation, created by hospitals, which began its operation in 1994. CareSource will be a new option for members. and can result in delayed or inappropriately denied treatments or services for the Hoosier Healthwise member. Browse 479 PBM job ($58K-$145K) listings hiring now from companies with openings. Hoosier Healthwise members will have an open enrollment period later this year to switch plans, if desired. From this site you'll be able to: View your health plan benefits and summaries MDwise Panel Add Request Fax Form to MDwise 317.829.5530 or 877-822-7190; or fax to your delivery system Provider Relations ** All fields must be complete for processing** ** Please print legibly – except signatures** Date of Request Contact Name Contact Telephone Member Information Hoosier Healthwise ID Number Member Name Mdwise.org Hoosier Healthwise and Healthy Indiana Plan For Hoosier Healthwise and Healthy Indiana Plan, MDwise customer service is available at 1-800-356-1204. Hoosier Healthwise and Health Indiana Plan: 1-866-408-6131; TTY 711 Hoosier Care Connect: 1-844-284-1797; TTY 711 Get the mobile app Let’s make healthy happen. DST Health Solutions pays Hoosier Healthwise claims for the Wishard, Methodist, and Total Health Delivery systems. For income requirements for Hoosier Healthwise, refer to the Eligibility Guide. The Today, MDwise provides Hoosier Healthwise services to approximately 122,000 members in partnership with 440 primary medical providers and approximately 2,800 specialists through its delivery systems. Lots of parents choose MDwise for Hoosier Healthwise! health plan (Anthem, MDwise Inc., or MHS), additional services may be available. MDwise is your local, Indiana-based nonprofit health care company. Package C (Children’s Health Insurance Program/CHIP) Our mission is to provide high quality health care. In the fall of 2016, a special open enrollment period was held for Hoosier Healthwise members to enroll with any one of the four health plans – Anthem, CareSource, MDwise, and MHS. Package C members can get ambulance transportation for emergencies at a greatly reduced cost. What's Here? The goals of Hoosier Healthwise are to: Package and Plan Information To determine the coverage package, review the Hoosier Healthwise letter of eligibility or call the HHW helpline at 1-800-889-9949. Therefore, fee-for-service providers, Hoosier Healthwise MCOs, and PrimeStep must honor outstanding PAs given within the program for services in the first 30 days of a member’s effective date in the new network. It is the State of Indiana’s health care program for children, pregnant women, and families with low income. Hoosier Healthwise MDwise St. Francis Advantage MDwise Healthy Indiana Plan (HIP) Description Hoosier Healthwise is Indiana's health care program for children, pregnant women, and low-income working families. MDwise works with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise, Healthy Indiana Plan and MDwise Marketplace health insurance programs. Hoosier Healthwise - MDwise Inc. Health Details: MDwise is your local, Indiana-based nonprofit health care company. HIP and Hoosier Care Connect Hoosier Healthwise 1-855-772-7125 1-800-457-4584 MDwise prior authorization contact information Hoosier Healthwise and HIP Delivery system PA phone number PA fax number MDwise St. Catherine 219-392-7066 (hospital authorizations only) 1-866-666-7327 (toll-free PAs) 219-392-7072 (all other PAs) 219-392-7090 What is Hoosier Healthwise? Indiana Medicaid – Hoosier Healthwise Eligibility. Anthem, MDwise, and MHS are the current MCEs serving the HIP and Hoosier Healthwise programs. Our mission is to provide high quality health care. The goals of the program are to provide health care to children and families, and to help prevent health problems with early medical care and treatment. Hoosier Healthwise members must use MDwise network pharmacies to access their prescription drug benefit. HIP Help is available from 8 a.m. to 8 p.m., Monday through Friday. Hoosier Healthwise (HHW) is one of the Indiana Medicaid programs. View statements from MDwise 1200 Madison Ave. #400, Indianapolis, IN, 4625 MDwise Hoosier Alliance, an AmeriHealth Caritas company, was a health care network that served as a delivery system for MDwise, Inc. from 2007 to 2015. MDwise Hoosier Alliance Jul 2007 - Jan 2011 3 years 7 months Oversee pharmacy benefits for medicaid managed care organization administering Hoosier Healthwise for the state of Indiana. In fact, over 400,000 Hoosiers trust MDwise to keep their families healthy. Packages A (Hoosier Healthwise/HHW) and P (pregnancy only coverage/presumptive eligibility for pregnancy women) can request transportation to medical appointments. Log in or create an account to view and maintain your CareFirst CHPDC access. Mdwise.org Get Deal ContinuCare order reminder program via phone and e-mail to Attention MDwise Medicaid Providers the claim submission for MDwise Hoosier Healthwise Actived: Wednesday Oct 31, 2018 (4 days ago) Mdwise.org *Hoosier Healthwise claims for St. Catherine, Select Health Network, and St. Vincent for DOS prior to 1/1/19 will continue to be processed by CMCS (payer ID 35199) About MDwise MDwise is an Indiana-licensed nonprofit health maintenance organization offering health care benefits to 300,000 Medicaid members. 4 General Hoosier Healthwise claims processing overview for MDwise In the MDwise plan, claims processing is delegated to the MDwise delivery systems MDwise has three payers. This is especially important for more than 360,000 elderly, low-income, youth, and other vulnerable populations served by MDwise plans such as Hoosier Healthwise, Healthy Indiana Plan, and Hoosier … Depending upon their health plan (Anthem, CareSource, MDwise Inc., or MHS), additional services may be available. It is a health care program administered by the Indiana Family and Social Services Administration. All Hoosier Healthwise members received advance notice of the open enrollment time frame, along with health plan summaries for the four health plan options. Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc., independent licensee of … The MDwise agreement is considered an Addendum to its Hoosier Healthwise Participating Provider Agreement. You may choose among the following: Anthem CareSource Managed Health Services (MHS) MDwise Visited 01/31/2018 Hoosier Healthwise and Healthy Indiana Plan For Hoosier Healthwise and Healthy Indiana Plan, MDwise customer service is available at 1-800-356-1204. Contact Us - MDwise Inc. Health Details: MDwise has customer service representatives that can talk to members in other languages.We can get an interpreter on the line for you. MHS Indiana offers health insurance in Indiana for those eligible for Indiana Medicaid or on the Health Insurance Marketplace. MDwise maintains its high commitment to communities through ongoing local and statewide involvement as a Hoosier Healthwise resource, both at the legislative and regulatory levels, as … Magellan Complete Care. When you enroll with Hoosier Healthwise, you must select a health plan. MDwise works with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise, Healthy Indiana Plan and MDwise … Learn more about our health plans and enroll today! Service Type PA Requirements Electroconvulsive Therapy ECT - 90870 Requires PA. Anesthesia (CPT code 00104) and outpatient facility (i.e., observation room) may also be … How do I use the formulary? At the current time, when you check eligibility for a HHW patient, you can see that the member participates in one of the three Managed Care Entities (MCE’s); Anthem, MHS, or MDwise including the name of the MDwise delivery system. MDwise BH contracted providers - outpatient prior authorization requirements for Hoosier Healthwise only. MDwise and Anthem Blue Cross and Blue Shield The following is a summary of the key provisions of the MDwise and Anthem Blue Cross and Blue Shield (“Anthem”) Healthy Indiana Plan (HIP) Provider Agreements that ISMA has prepared. 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