The thousands of participants served by the various programs administered by the Indiana State Department of Health are fortunate to have the participation of excellent health care providers across the wide spectrum of medical specialties. Their significant contribution to the well being of this sector of Indiana's population is appreciated.
IMPORTANT EOP (REMITTANCE ADVICE) NOTICE FOR PROVIDERS
Effective 1/1/2012 providers need to obtain EOP information from the Children's Special Health Care Services (CSHCS) Web Portal. We will not be able to provide EOP information over the telephone. The CSHCS Program has previously sent 2 notifications to providers that the program will no longer send a paper EOP (for paid or denied claims) to providers after 12/31/2011.
If you have not already done so, please enroll in the Web Portal now by clicking on the Web Portal link to the left of this page and completing the short enrollment form. Please be sure any third party billers that you would like to have access to the Web Portal information are also listed on your enrollment form. The Web Portal will allow providers to view and/or print EOPs and check claim & enrollment status. Another option would be to contact our EDI team at 1-800-475-1355, option 5, then option 1 to inquire about receiving the 835 Electronic Remittance Advice.
835 Change Notice
Effective on 1/1/2014, the Indiana State Department of Health (ISDH), Children's Special Health Care Services (CSHCS) Program will implement changes to V5010 835 Electronic Remittance Advice (ERA). The ISDH, CSHCS will be populating TRN04 - Reference Identification with the value 400C(2-digit Fiscal Year)SNM. This new value represents the CSHCS PROGRAM within the ISDH Agency. Please make changes accordingly to accommodate this newly populated data element.
Provider Document Download Center
- Provider Agreement
- Individuals Covered Under Provider Agreement
- Schedule B
- Web Portal
- Direct Deposit Form
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.
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.
- Bulletin 1, August 2003
- Bulletin 2, September 2003
- Bulletin 3, February 2007
- Bulletin 4, May 2007
- Bulletin 5, May 2007
- Bulletin 6, November 2009
- Bulletin 7/8, March 2011
- Bulletin 9, October 2011
- Bulletin 10, December 2011
- Bulletin 11, January 2014
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 6.