alert

FSSA/OMPP wants to make Medicaid better for members and they need your help. Apply to join Indiana Medicaid’s NEW Beneficiary Advisory Council (BAC) to share your experience. The BAC, composed of current and former Medicaid members and caretakers, will discuss policy and program changes. To apply, complete the BAC application and submit it via email or mail. Additionally, here is the website link for the FSSA BAC page: https://www.in.gov/fssa/ompp/advisory-committees/beneficiary-advisory-council

Provider Balance Billing

It is important to remember, except for a very few exceptions, a Medicaid member cannot be billed for health care services. Please review the MDwise provider manual for these exceptions and the criteria you must meet before billing a member.

If a provider has received payment on a Medicaid claim, the member may never be asked to pay an additional amount, or be balance-billed, for that claim. When cost-sharing is no longer suspended, providers may bill a Healthy Indiana Plan (HIP) member for a co-pay if the member was unable to pay at the time of service. These co-pays are anywhere from $4 for an office visit to $75 for a hospital stay.