Print Page   |   Contact Us   |   Report Abuse   |   Sign In   |   Register
Indiana Medicaid Programs
Share |

IPN has developed the following guides to providers and organizations addressing the health care and insurance needs of low-income Indiana residents.

Presumptive Eligibility and Notification of Pregnancy Form

Presumptive Eligibility

PE Overview Webinar - Click here to view a short webinar on the basics of Presumptive Eligibility, presented by Caitlin Priest, MPH from Covering Kids and Families of Indiana

For more information about Presumptive Eligibility, including patient educational brochures and the Notification of Pregnancy Form, visit http://www.indianamedicaid.com/ and click on "Providers" and then on "Presumptive Eligibility".

Click here for key facts about Presumptive Eligibility.

Click here to find a Presumptive Eligibility Qualified Provider.

What You'll Want to Know — 3 important facts about Presumptive Eligibility:

  1. Presumptive eligibility (PE) allows a pregnant woman to receive ambulatory prenatal services while her Hoosier Healthwise (Medicaid) application is being processed.
  2. No documentation is required from the pregnant woman for the Qualified Provider to make the determination that a woman is presumptively eligible.
  3. Providers that bill for services while a woman is on PE will not have reimbursement taken back if the woman is later found ineligible for Medicaid.

New Notification of Pregnancy Form

Effective July 1, 2009, the Office of Medicaid Policy and Planning has launched a new Notification of Pregnancy form for use with pregnant Medicaid recipients.

Click here for key facts about the Notification of Pregnancy form.

What You'll Want to Know — 3 important facts about the new Notification of Pregnancy form:

  1. The Notification of Pregnancy (NOP) form is a comprehensive risk assessment used by all three Medicaid managed care organizations. NOPs have been associated with improving birth outcomes for women enrolled in Medicaid.
  2. Prenatal care providers that complete and electronically submit the NOP using Web interChange may receive $60 for each form submitted within 5 days of seeing the patient.
  3. The NOP risk assessment includes questions about maternal and obstetrical history, mental health, substance abuse, and social risk factors. The Medicaid MCOs will use this information to identify and address risk factors, and ultimately, to improve birth outcomes.

For more information, contact Larry Humbert at (317) 924-0825 or lhumbert@indianaperinatal.org

Other Helpful Links:

Contact Us

Indiana Perinatal Network
1991 E. 56th St.
Indianapolis, Indiana 46220
Phone: 866.338.0825
Email Us