Welcome Indiana Behavioral Health Providers
Indiana Medicaid Network Participation

How to submit an Optum participation request
Credentialing requirements
Individual Clinician requirements
Individual clinician step-by-step guides
Agency requirements
Facility requirements
Autism/Applied Behavior Analysis (ABA)
Submitting additional required information
Important materials about joining the network
- Behavioral Health Provider Directory
- HIPAA and 42 CFR Part 2 Privacy Policy and Procedures
- Indiana Medicaid: Providers: FAQs – Top 10 Questions
- Indiana Medicaid Website
- Individual Health Record™ User Guide
- Outpatient Care Engagement Program Overview
- Provider Policy and Procedure Manual and Associated Forms
- Top of Mind monthly newsletter
For BH prior authorization, please submit the Universal PA form to 844-897-6514.
- Universal Prior Authorization Form
- Substance Use Disorder (SUD) Universal Prior Authorization Form
- IHCP SUD Admission Assessment Form
- IHCP SUD Reassessment Form
- Psych-Neuropsych Prior Authorization Request Form
- United Healthcare Community Plan of Indiana Hoosier Care Connect Behavioral Health Prior Authorization List
For appeals information: uhcprovider.com/Indiana
UnitedHealthcare Community Plan
P.O. Box 5240
Kingston, NY 12402-5240
Contact Us
For Treatment/Authorizations, Benefits/Eligibility, Claims, Appeals or any other member-related issue, access the Secure Transactions on Provider Express or call the Customer Service number on the back of the member's ID card.
Provider Relations Advocate
Paulette Means (Northern Indiana Counties)
Main Number: (612) 476-6567
Fax Number: (855) 572-3643
Northern Indiana Counties: Adams, Allen, Benton, Blackford, Carroll, Cass, Clinton, DeKalb, Elkhart, Fulton, Grant, Howard, Huntington, Jasper, Jay, Kosciusko, LaPorte, LaGrange, Lake, Marshall, Miami, Newton, Noble, Porter, Pulaski, St Joseph, Starke, Steuben, Tippecanoe, Tipton, Wabash, Warren, Wells, White, Whitley
Kristin Johnson (Southern Indiana Counties)
Senior Provider Relations Advocate
Main Number: (763) 330-4335
Fax Number: (855) 572-3643
Southern Indiana Counties: Bartholomew, Boone, Brown, Clark, Clay, Crawford, Daviess, Dearborn, Decatur, Delaware, Dubois, Fayette, Floyd, Fountain, Franklin, Gibson, Greene, Hamilton, Hancock, Harrison, Hendricks, Henry, Jackson, Jefferson, Jennings, Johnson, Knox, Lawrence, Madison, Marion, Martin, Monroe, Montgomery, Morgan, Ohio, Orange, Owen, Parke, Perry, Pike, Posey, Putnam, Randolph, Ripley, Rush, Scott, Shelby, Spencer, Sullivan, Switzerland, Union, Vanderburgh, Vermillion, Vigo, Warrick, Washington, Wayne
Indiana Autism/ABA Network Management
Olivia Smith
Main Number: (715) 833-6538
Fax Number: (855) 572-3643
Optum network manuals
Best practice guidelines
InterQual Level of Care Guidelines are used and criteria can be provided upon request for specific cases.
ASAM Level of Care Guidelines are used for Substance Use Disorder (SUD).
Additional information and forms are available, including psych/neuropsych testing guidelines, credentialing plans, and Disability Solutions Manual, on the Provider Express Guidelines/Policies & Manuals and Optum Forms pages.