Ind. IHCP Hospice Services Provider Reference Module, Section 6, Medicaid-Only Hospice Member Residing at Home

If a Medicaid-only hospice member residing at home (that is, in any residential setting other than a nursing

facility) has private insurance, the hospice provider must first bill the private insurance for hospice services.

When the private insurance company denies or partially pays the claim, the hospice provider can bill the

IHCP for the remaining balance for the hospice services.

If the private insurance company has denied payment for hospice services, in whole or in part, the hospice

provider must complete a UB-04 claim form or electronic equivalent and attach a copy of the notice from

the private insurance company outlining the denial of payment for those dates of service. (For claims

submitted via the IHCP Portal, attachments may be uploaded electronically; for 837 transactions,

attachments must be submitted separately by mail, as described in the Claim Submission and Processing

module.) Upon receipt of all documentation, the IHCP processes the claim for payment.