Provider Resources
- Provider Manual
- CSHCS Brochure (English | Spanish)
- CSHCS Provider Agreement Packet
- Provider Agreement
- Individuals Covered Under Provider Agreement
- Schedule B
- Web Portal
- Direct Deposit Form
- W-9
Electronic Data Interchange/Trading Partner Agreement
CSHCS accepts electronic transactions. If you would like to submit claims electronically, please complete one of each of the forms below.
- 51402 – Electronic Data Interchange (EDI)
- 51441 – EDI Clearinghouse
- 51401 – EDI Provider
Please note that after completion of these forms, they must be sent to the Children's Special Health Care Services Program at 2 N. Meridian Street, Section 5C, Indianapolis, IN, 46204; by fax to 1-317-233-1342; or call for an email address. Please do not send directly to the Auditor of State's office.
CSHCS Policy Library
We have created a listing of all policies that are pertinent to our program for participants and providers.
If you have any questions regarding any policy, please feel free to contact a Provider Relations Specialist for clarification at 1-800-475-1355 (in state) or 1-317-233-1351, Option 5.