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PAYMENT & REIMBURSEMENT

Payment Advocacy

Did You Know?

As a member benefit, IHCA/INCAL staff can intervene on your behalf with regulators and insurers to assist in finding a solution to challenges you are facing.

IHCA/INCAL staff maintain knowledge and connections with fee for service and managed care organization personnel in both Medicaid and Medicare to help IHCA members obtain payment and reimbursement.

IHCA/INCAL are able to assist members with claims payment, Level of Care and other issues.

IHCA/INCAL has been successful in the past in lobbying for a delay in certain new regulations and programs that affect reimbursement in our sector.

Also, the Director of Reimbursement hosts a quarterly IHCA Payor Workgroup meeting comprised of IHCA members as well as representatives from Medicaid managed care companies, Medicare plans, the Office of Medicaid Policy and Planning, DXC (the state’s fiscal agent) and the Division of Aging to discuss various reimbursement policy issues and policies.

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Medicaid

Indiana’s Case Mix reimbursement system is complex and frequently changing. We track and provide guidance on a range of matters from Quality Assessment Fee to Payment Add-ons to Value based Purchasing to Cost Reports and Audits.

We also engage in policy development and expansion of Medicaid Long Term Services and Supports, Medicaid Waiver and Home and Community Based Services.

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Medicare

The intersection of quality and payment in the Medicare program continues to advance at a rapid pace. We help members learn and adapt to these changes. Data and guidance on the Patient Driven Payment Model, SNF VBP, Quality Reporting Program, are available for members to access.

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Got Questions?

Elizabeth Eichhorn, director of reimbursement policy and payor affairs  can help!

EMAIL ELIZABETH