Provider Relations

Provider Portal

Look up member claims, eligibility and more.
To request access: Email us, call 317-621-7580 or fax request form to 317-355-6084.

Contact Provider Relations

Phone: 317-621-7581
Fax: 317-621-7470




Jenny Provider relations manager E-mail Jenny
Lori W. Medicare program manager E-mail Lori W.
Salena Medicaid program manager E-mail Salena
Amanda Provider relations coordinator E-mail Amanda
Carol Provider relations coordinator E-mail Carol
Dawn Provider relations coordinator E-mail Dawn
Hollie Business information coordinator E-mail Hollie
Jenna Credentialing and enrollment supervisor E-mail Jenna
Adrianne Credentialing coordinator E-mail Adrianne
April Credentialing coordinator E-mail April
Aletha Credentialing coordinator E-mail Aletha
Julia Credentialing coordinator E-mail Julia
Julie Credentialing coordinator E-mail Julie
Kim Credentialing coordinator E-mail Kim
Amy Provider enrollment coordinator E-mail Amy
Denise Provider enrollment coordinator E-mail Denise
Dianne Provider enrollment coordinator E-mail Dianne
Lori J. Provider enrollment coordinator E-mail Lori J.
Melissa Provider enrollment coordinator E-mail Melissa
Sharon Provider enrollment coordinator E-mail Sharon

Provider forms and information

ProHealth Provider ManualPrint and fill out the following forms and submit them to our office:

Provider directories

Gold and Silver Plans

Providers not listed in the above directories are Tier 3.

MDWise and Hoosier Healthy Indiana Plans

Fee schedule information

Provider newsletters


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Payer information

Please note: Not all ProHealth providers participate in all plans.

Credentialing information

To become a participating provider with Indiana ProHealth Network you must have a completed and up-to-date CAQH application. If you would like ProHealth to obtain this application for you, please complete the CAQH Provider Data Sheet. Otherwise, please see the CAQH website for additional information at

To inquire about being in ProHealth, please e-mail Jenna.

Credentialing requirements checklist:

Electronic COB information acceptance

ProHealth is accepting Other Payer Primary COB information within your electronic claims. Please submit Primary Other Payer processing information using HIPAA-standard codes and amounts at the line-item detail level within your electronic claim files. Electronically submitted Primary COB information is processed at initial adjudication, and eliminates secondary paper claim and paper primary EOB submission requirements when ProHealth is the secondary payer.

EFT/835 enrollment

ProHealth is accepting EFT/835 enrollment. Please submit the completed 835/EFT enrollment forms to Michele Dowd at 317-355-6084 (fax) or