This page provides useful contact information for Indiana Health Coverage Programs (IHCP) hospice providers.
Managed Care Information: Hoosier Healthwise members must be transitioned to fee-for-service (FFS) Traditional Medicaid to receive the IHCP hospice benefit; see the Authorization of Services for Hospice Members section below for details.
For members enrolled in Healthy Indiana Plan (HIP), Indiana PathWays for Aging or Hoosier Care Connect, contact the member’s managed care entity (MCE) for information about hospice services.
Program of All-Inclusive Care for the Elderly (PACE) participants should contact their PACE program when considering hospice services; if PACE disenrollment is required to access hospice services, the PACE program will facilitate the transition to FFS coverage.
For MCE and PACE contact information, see the IHCP Quick Reference Guide.
Authorization of Services for Hospice Members
Submit FFS hospice authorization requests, as well as required forms and supporting documentation, to Acentra Health (the IHCP FFS prior authorization and utilization management [PA-UM] contractor) via the Atrezzo Provider Portal or by mail or fax:
Acentra Health
6802 Paragon Place, Suite 440
Richmond, VA 23230
Acentra Health Fax: 866-261-2774
For questions about hospice authorization, call:
Acentra Health Customer Service: 866-725-9991
For Hoosier Healthwise members wishing to elect IHCP hospice benefits, fax the completed Medicaid Hospice Election form to Acentra Health and indicate, "Hospice Member Disenrollment from Managed Care" on the cover page of the fax. After submitting the fax, call Acentra Health Customer Service to confirm that the fax was received. Acentra Health will coordinate the with Maximus, the IHCP managed care enrollment broker, to transition the member to FFS.
Hospice Claim Billing
Submit FFS hospice claims to Gainwell Technologies. FFS hospice claims may be submitted via the IHCP Provider Healthcare Portal, using the 837 electronic transaction or by mail to:
Gainwell – UB-04 Claims
PO Box 50448
Indianapolis, IN 46250-0418
For questions about hospice billing, call:
IHCP Customer Assistance: 800-457-4584
Or contact the appropriate Gainwell Provider Relations consultant.
Hospice Agency Licensing and Certification Program – Indiana Department of Health (IDOH)
Division of Home- and Community-Based Care
Indiana Department of Health
2 N. Meridian St., Section 4B
Indianapolis, IN 46204
Phone: 317-233-1325
IDOH Hospice Agency Licensing and Certification Program
Indiana Chapter for the National Hospice & Palliative Care Organization (IHPCO)
Indiana Hospice & Palliative Care Organization, Inc.
P.O. Box 68829
Indianapolis, IN 46278-0829
Phone: 317-464-5145
ihpco.org
Indiana Assisted Living Association (INALA)
Indiana Assisted Living Association
6280 W. 96th St.
Indianapolis, IN 46268
Phone: 317-733-2390
inassistedliving.org
Indiana Association for Home and Hospice Care (IAHHC)
Indiana Association for Home and Hospice Care
6320-G Rucker Rd.
Indianapolis, IN 46220
Phone: 317-775-6675
Fax: 317-775-6674
iahhc.org