Provider
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.
Provider Document Download Center
Provider Agreement:
- Provider Agreement Packet
- Billing Provider Update Form
- Group Member Update Form
- Change of Ownership Form
Children’s Special Health Care Services Program:
Indiana W9 Form Request for Taxpayer ID #
Electronic Data Interchange/Trading Partner Agreement:
The Children's Special Health Care Services program accepts electronic transactions. Please see EDI Solutions link above for more information
Provider Bulletins:
Bulletin 1, August 2003
Bulletin 2, September 2003
Bulletin 3, February 2007
Bulletin 4, May 2007
Bulletin 5, May 2007
- Where do I obtain a copy of an Indiana birth or death certificate?
- What is INShape Indiana?
- How do I create an INShape account?
- Where is the INShape Indiana login page?
- Can I talk to an INShape Indiana fitness trainer about my specific health needs?
- Is the old INShape Indiana tracking system still available?
- Can I talk to an INShape Indiana nutritionist about my specific health needs?
- As an adopted child, how do I get information about my birth parents?
- How do I request a representative from INShape Indiana to attend my event?
- How can I find out more about the flu epidemic?
