Primary Medical Provider Network Participation Requirements
Primary Medical Provider (PMP)
MDwise works to have a quality network of providers for its members to choose from. Please read the following requirements that providers must meet before they can accept a panel as an MDwise Primary Medical Provider (PMP).
MDwise PMPs are defined as general practice, family practice, pediatrics, physician assistants, internal medicine, obstetrics/gynecology, advanced nurse practitioners, and endocrinologists (if primarily engaged in internal medicine).
Specific PMP Duties
The Primary Medical Provider (PMP) is an integral part of the MDwise managed health care program. The PMP functions as the central access point for MDwise members. MDwise PMP’s coordinate all covered service for their assigned members, except for self-referral and carved-out services. This includes guiding members to participating specialists and hospitals when necessary and maintaining continuity of each member’s health care.
Each PMP who participates with MDwise must agree to the following participation requirements:
Policies and Procedures
- Follow all MDwise policies and procedures in addition to all Federal and State requirements for the Hoosier Healthwise, Healthy Indiana Plan (HIP)
- MDwise policies are described in the Provider Manual
If you have any questions about these policies, call your provider relations representative or call MDwise Customer Service at 1-800-356-1204.
IHCP Enrollment
- All eligible provider types and specialties must be actively enrolled with IHCP and linked to their requested service location prior to submitting a network participation request to MDwise.
Panel Size
Accept and maintain a member panel, based on the participating program.
- Hoosier Healthwise: 150-2000 members
- Healthy Indiana Plan: 25-2000 members
If you meet these requirements and need more information on joining our exceptional provider network, please visit our Become an MDwise Provider page.