Why Does The Eligibility System Not Always Display The MDwise Network?
MDwise participates in 3 Medicaid Programs; MDwise Care Select, Hoosier Healthwise, and HIP. Not all of these MDwise Programs have network affiliations. Many assume when they see “MDwise” on eligibility that the member has a specific network affiliation. Not true…
The “Managed Care” section of the Web interChange will convey the type of managed care, Care Select or Hoosier Healthwise.
The “Managed Care Entity Name” will convey with which managed care company the member is enrolled (Advantage, Anthem, MDwise, or MHS).
It is critical to review both sections to determine if a network is applicable.
| Managed Care | Managed Care Entity Name | MDwise Network |
| Care Select | MDwise | This Program has no networks. Claims for these members are processed by HP. |
| Hoosier Healthwise Risk Based Managed Care | MDwise | Members enrolled in the Hoosier Healthwise MDwise Plans will have a network assignment displayed on the eligibility screen. |
| HIP | MDwise | While the MDwise HIP Program does have networks, they are not displayed on the eligibility systems. You must call MDwise HIP to obtain information about the specific network. |
