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Page 1 of 80 Indiana Department of Insurance Patient’s Compensation Fund 311 W. Washington Street, Suite 103 Indianapolis, IN 46204 [email protected] (317) 232-2401 Certificate of Insurance Electronic Filing Procedures Version Date Version Number 10/26/2017 1.0
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Page 1: Certificate of Insurance Electronic Filing Procedures...subscription allows user to manually enter and file an unlimited number of certificates for one year from date of enrollment.

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Indiana Department of Insurance Patient’s Compensation Fund

311 W. Washington Street, Suite 103

Indianapolis, IN 46204

[email protected]

(317) 232-2401

Certificate of Insurance

Electronic Filing Procedures

Version Date Version Number

10/26/2017 1.0

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Table of Contents

Contents

Home Page .................................................................................................................. 5

User Types and Permissions ..................................................................................... 6

Carrier Admin ......................................................................................................... 6

Carrier Payer .......................................................................................................... 7

Carrier Filer ........................................................................................................... 8

Producer ................................................................................................................. 9

Create New Account ................................................................................................ 10

Step 1A - Carrier Admin ..................................................................................... 10

Step 1B - Producer Account.................................................................................. 11

Step 2 ..................................................................................................................... 12

Step 3A - Carrier Admin ..................................................................................... 13

Step 3B - Producer ................................................................................................ 14

Submit a Certificate ................................................................................................. 15

File a New/Renewal Certificate ............................................................................ 16

Step 1 .................................................................................................................... 17

Step 2 ..................................................................................................................... 18

Step 3A - Hospitals ............................................................................................... 20

Step 3B – Nursing Homes ..................................................................................... 23

Step 3C - All Other Types ..................................................................................... 25

Step 4 ..................................................................................................................... 26

Step 5 ..................................................................................................................... 27

File an Amended / Cancellation Certificate .................................................. 28

Search for Certificate ........................................................................................... 28

File an Amendment ............................................................................................... 29

Step 1 ..................................................................................................................... 30

Step 1A – Nursing Homes and Hospitals .............................................................. 31

Step 2 ..................................................................................................................... 32

Step 3 ..................................................................................................................... 33

File a Cancelation ................................................................................................ 34

Step 1 ..................................................................................................................... 35

Step 3 ..................................................................................................................... 36

Step 1 ..................................................................................................................... 38

Step 2 ..................................................................................................................... 39

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Step 3 ..................................................................................................................... 40

Step 4 ..................................................................................................................... 41

Step 5A – Credit Card ........................................................................................... 42

Step 5B – Credit Card ........................................................................................... 43

Step 5C – Credit Card .......................................................................................... 44

Step 5D - eCheck ................................................................................................... 45

Step 5E – eCheck .................................................................................................. 46

Step 5F – eCheck .................................................................................................. 47

Step 5G – eCheck .................................................................................................. 48

Step 6 ..................................................................................................................... 49

Step 7 ..................................................................................................................... 50

View Previous Fillings ............................................................................................. 51

Step 1 ..................................................................................................................... 52

Step 2 ..................................................................................................................... 53

Search Payments ...................................................................................................... 54

Step 1 ..................................................................................................................... 55

Step 2 ..................................................................................................................... 56

Step 3 ..................................................................................................................... 57

Credits and Reports ................................................................................................. 58

Step 1 ..................................................................................................................... 59

Step 2 ..................................................................................................................... 60

Admin Management ................................................................................................ 61

Creating a User ......................................................................................................... 62

Step 1 .................................................................................................................... 63

Bulk Submission ....................................................................................................... 64

Step 1 ..................................................................................................................... 65

Step 2 ..................................................................................................................... 66

Step 3 ..................................................................................................................... 67

Step 4 ..................................................................................................................... 68

Step 5 ..................................................................................................................... 68

Step 6 ..................................................................................................................... 69

Step 7 ..................................................................................................................... 70

Step 8 ..................................................................................................................... 71

Bulk Search ............................................................................................................... 72

Step 1 ..................................................................................................................... 73

Step 2 ..................................................................................................................... 74

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Step 3 ..................................................................................................................... 75

Step 5 ..................................................................................................................... 76

Step 6 ..................................................................................................................... 78

Step 7 ..................................................................................................................... 79

Step 8 ..................................................................................................................... 80

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Home Page

The User name field is required. User name is case sensitive and can only contain numbers (0-9) and letters (A-Z).

Special characters (!@#$%^&*) are not allowed. There is no minimum number required in this field, but the maximum

is 20 letters and/or numbers.

The Password field is required. Password must contain at least 6 characters, with at least one (1) letter and one (1)

number. Special characters (!@#$%^&*) are allowed. The maximum number of characters, letters and/or numbers is

10.

Click the Forgot User Name link to proceed with retrieving user name. Click the Forgot Password link to proceed

with retrieving password.

Click Continue to proceed with registration.

*If you have previously created your account, then enter a valid username and password and click the

Submit button to navigate to the dashboard.

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User Types and Permissions There are 4 types of users (roles) on the IPCF application. Designated rights for each role are as follows:

Carrier Admin

Includes permissions to Submit a Certificate, Make Payments, View Previous Filings, View Credits and Reports,

Admin Management, Search Payments, Bulk Submissions, and Bulk Search

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Carrier Payer

Includes permissions to Submit a Certificate, View Previous Filings, View Credits and Reports, Bulk Submissions, and

Bulk Searches

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Carrier Filer

Includes permissions to Submit a Certificate, View Previous Filings, View Credits and Reports, Bulk Submissions, and

Bulk Searches

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Producer

Includes permissions to Submit a Certificate, Make Payments, View Previous Filings, View Credits and Reports, Search

Payments, Bulk Submissions, and Bulk Searches

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Create New Account Step 1A - Carrier Admin

All fields are required.

Enter the NAIC Code for the carrier you are creating an account for.

Enter the full legal name of the insurance carrier you are registering.

Click Continue to proceed with registration.

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Step 1B - Producer Account

To register, producer must provide last name and valid license number.

Click Continue to proceed with registration.

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Step 2

All fields are required.

User name is case sensitive and can only contain numbers (0-9) and letters (A-Z). Special characters (!@#$%^&*) are

not allowed. There is no minimum number required in this field, but the maximum is 20 letters and/or numbers.

Password must contain at least 6 characters, with at least one (1) letter and one (1) number. Special characters

(!@#$%^&*) are allowed. The maximum number of characters, letters and/or numbers is 10.

Select a security question and provide an answer. Answer is not case sensitive.

Click Continue to proceed with registration.

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Step 3A - Carrier Admin

If you would like to enroll for unlimited subscription, please click Yes, Proceed to Checkout. An unlimited

subscription allows user to manually enter and file an unlimited number of certificates for one year from date of

enrollment. The fee for this service is $1,500.00.

Additionally, there is an option of enrolling for Bulk Submissions, which allows you to upload a file to submit

certificates. The fee for this service is $5,000.00.

If you do not wish to enroll for unlimited subscription, please click No, Go to dashboard.

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Step 3B - Producer

If you would like to enroll for unlimited subscription and bulk submissions, please click Yes, Proceed to Checkout. An

unlimited subscription allows user to enter and file an unlimited number of certificates for one year from date of

enrollment as well as use bulk submissions to file. The fee for this service is $5,000.00.

If you do not wish to enroll for unlimited subscription, please click Go to dashboard.

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Submit a Certificate

Click Continue to proceed with filing.

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File a New/Renewal Certificate

To file a new or renewal certificate, please click File a New/Renewal Certificate.

To Amend or Cancel a previously submitted certificate, please click File an Amended/Cancellation Certificate. A

certificate that has been filed previously on paper cannot be amended electronically; you may only amend or cancel on

paper.

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Step 1

Please enter a valid Indiana Medical License # or EIN.

If this is a new provider enrollment with the PCF, please contact [email protected] to have provider added to the

PCF website database. Your request should be completed within 24 hours.

If you have previously amended the Medical License # or EIN, you should have notified IDOI to make this change in

the PCF website database. If you have not already done so, please contact [email protected] to request this change to

the PCF website database, and then you may proceed with filing this certificate.

Click Continue to proceed with filing.

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Step 2

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Take note of the Provider Type as this will determine what steps are required to finish creating a certificate.

All fields are required except for the Date Surcharge Received From The Provider and D.B.A.’s. If adding a

D.B.A. type in the name and either click Add or highlight the name and click Remove Selected.

An ISO Code may only contain five numbers.

Health Care Provider Name should be the full legal name of provider. When editing an individual’s name, please enter

in the following format: John E. Doe (First/Middle/Last)

D.B.A. - You may enter as many D.B.A.’s as needed, but you must enter them one at a time, and then click Add. You

may also remove a d.b.a. from the list by selecting the name of the d.b.a. and then click Remove Selected.

EIN / Medical License Number may be edited on this page. PLEASE BE AWARE that modifying an EIN or License

Number will not update the Agency website. Please contact [email protected] to request this change be made to the

Indiana Patient’s Compensation Fund database.

Policy Number may contain numbers or letters. Type of Policy must be selected. When choosing a claim made or

reporting endorsement, a retro date must be entered. The retro date is the date of the first claims made policy with

the Indiana Patient’s Compensation Fund. This date might be different from the underlying retro date. If the

underlying policy is an occurrence policy, no other date is required.

Coverage dates – enter the policy effective dates. Dates may not exceed one year, except for reporting endorsements. If

entering coverage dates less than a year, you will be asked to verify later if this is a Pro- Rated or Locum Tenen policy.

Start coverage date may not exceed 180 days of the date certificate is submitted. If the coverage dates are between 91

and 180 days late from the policy effective date, the certificate will require agency verification. Information will be

saved on the electronic filing system, but will not be processed until approved by the IDOI. Please submit an Appeal

Letter and No Known Claims Loss Letter directly to [email protected] for approval. You may also use this email

address if you have further questions regarding the appeal procedure. Once the filing is approved or denied, you will be

notified whether to proceed with payment of surcharge and penalties.

Date Surcharge Received from the Provider – this is an optional field. It is the date that surcharge was received by the

carrier from the provider.

Minimum Occurrence Limits of Liability will fill out automatically to attempt to correspond with current statues. This

field cannot have a lesser amount, but the minimum occurrence limit of liability may be a greater amount. Minimum

Aggregate Limits of Liability is will be auto filled to correspond with current statues. The minimum aggregate limit of

liability may be higher depending on the type of provider, such as for a Nursing Home or Hospital. If the actual limits

of liability are greater than the minimum requirements, then those limits must be entered. It is your responsibility to

make sure the limits are entered in properly.

Premium Amount field is not required for hospitals and nursing homes. All other provider types must have amount

entered in this field, even if the carrier has not charged the provider a premium for the policy. In this case, you may

enter 0.

Click Continue to proceed with filing.

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Step 3A - Hospitals

Any entity, person or activity not identified in this surcharge worksheet might not be included in the hospital’s coverage

with the Patient’s Compensation Fund.

Please enter the number of registered beds, number of visits, and number of surgeries and births.

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All employed physician names must be entered under the correct specialty class code. Click the green plus (+) sign, type

in physician name, and then click Add Physician. Each physician must be added separately. The total number of

physicians will be calculated automatically on the worksheet.

If you would like to remove a physician, click Remove Physician.

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Please verify whether Lack of Risk Management Program or Hospital with >500 Beds option applies.

Click Calculate Surcharges, and Sub Totals will populate on the worksheet.

Click Continue to proceed with filing.

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Step 3B – Nursing Homes

Any entity, person or activity not identified in this surcharge worksheet might not be included in the nursing home’s

coverage with the Patient’s Compensation Fund.

Please enter the number of Extended Care/Intermediate Care/Residential and/or Nursing Home/Critical

Extended/Comprehensive Care.

All employed physician names must be entered under the correct specialty class code. Click the green plus (+) sign,

type in physician name, and then click Add Physician. Each physician must be added separately. The total number of

physicians will be calculated automatically.

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Please verify whether Lack of Risk Management Program option applies.

Click Calculate Surcharges, and Sub Totals will populate.

Click Continue to proceed with filing.

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Step 3C - All Other Types

This includes these Provider Types: Ancillary Providers, Independent Ancillary Providers, and All Other Types

Credit selection is a required field. By default, the system selects I have no credits. Please verify that this is the correct

selection before proceeding.

If you have previously entered pro-rated coverage dates, then you will be asked to verify if this is a Pro-Rated or

Locum Tenen policy.

Click the Continue button to proceed with filing.

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Step 4

Please verify that all information is accurate and then click Submit. If there are any errors, please click the

Back button.

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Step 5

After you have submitted certificates, they will appear in this list. You may sort by any of the header fields by clicking

once. If you notice a P instead of a check box on the left side of the grid that means the certificate is being reviewed by

IDOI and will need to be approved by them before continuing. Once approved an email will be sent.

You may select an individual certificate to view, or select ones to add to the payer queue, or delete any certificate.

To add to the payer queue, select the certificate(s) and click the Add Selected Filings to Payer Queue

button.

To delete the certificate, select the certificates(s) and click the Delete Selected button.

WARNING: Deleted certificates cannot be retrieved and must be re-entered.

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File an Amended / Cancellation Certificate Search for Certificate

You may search for a previously submitted certificate by entering information into any of the search fields. Your search

can be narrowed by entering as much known information as possible. The Certificate Confirmation Number was

provided via email when the certificate was previously submitted.

Click Submit to proceed.

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File an Amendment

Previously submitted certificates will appear in a list. By clicking the box next to the certificate, you may amend or

cancel by clicking on Amend or Cancel.

You may also export an individual certificate or select all to export all certificates to a .PDF list. If you would like to go

back to the Dashboard, click Back to Dashboard.

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Step 1

The fields have auto-populated with the original information for your review and confirmation. You now have the

option to edit the fields at the bottom of the page. Please enter new information carefully.

Click Continue to proceed with filing.

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Step 1A – Nursing Homes and Hospitals

Nursing Homes and Hospitals will have an additional step for amending. At this step, you will need to specify if there

are any changes to the bed counts or physicians associated with the policy. After making or confirming the changes the

click the Calculate Surcharge button then Continue to move to the next step.

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Step 2

The Effective Date is the date of the amendment has become or will become effective. The Effective Date is required.

A change reason must be given.

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Step 3

The certificate that has been amended will now show a status of Amendment. You may continue to search for and

amend or cancel more certificates, or you may proceed to Add Selected Filings to Payer Queue.

If you notice a P instead of a check box on the left side of the grid that means the certificate is being reviewed by IDOI

and will need to be approved by them before continuing. Once approved an email will be sent.

When finished, click Back to Dashboard.

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File a Cancelation

Previously submitted certificates will appear in a list. By clicking the box next to the certificate, you may amend or

cancel by clicking on Amend or Cancel.

You may also export an individual certificate or select all to export all certificates to a .PDF list. If you would like to go

back to the Dashboard, click Back to Dashboard.

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Step 1

At the top of this page is the information that was originally submitted for this provider. You now have the option to edit

the fields at the bottom of the page.

The Effective Date is the date of the cancellation has become or will become effective. PLEASE NOTE:

Termination or change shall not be effective unless notice of same has been delivered via the electronic filing

system to the Department of Insurance, State of Indiana, not less than thirty (30) days prior to such change.

Please enter new information carefully. A Cancellation Reason must also be given.

Click Continue to proceed with filing.

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Step 2

The certificate that has been cancelled will now show a status of Cancellation. You may continue to search for and

amend or cancel more certificates, or you may proceed to Add Selected Filings to Payer Queue.

If you notice a P instead of a check box on the left side of the grid that means the certificate is being reviewed by IDOI

and will need to be approved by them before continuing. Once approved an email will be sent.

When finished, click Back to Dashboard.

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Make Payments

Click Continue under Make Payment option on the Dashboard to make payment for selected filings.

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Step 1

Make Payments will list out the New Filings, Renewals, Cancelations, and Amendments you have added to the payer queue

from the Manage Certificates page.

You may select an individual certificate to view by clicking the check box next to the provider name or Select All to

make your payment. You may also sort by any of the header fields by clicking on the header name.

You may view any available credit balance on the Dashboard under Credits and Reports prior to beginning the

checkout process.

The Tier Pricing Structure appears at the bottom of the screen. This fee will automatically be inserted according to the

number of certificates that are being submitted in one payment. If you have enrolled for the Unlimited Subscription

option, there will be no additional fee attached to this filing, other than the surcharge amount(s).

To proceed, click Pay Selected Filings. A “Please Wait” icon will appear.

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Step 2

After selecting the certificates and clicking Pay Selected Filings you will be taken to a verification page. To continue you

must select the I Agree checkbox and click Continue.

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Step 3

After verifying you will be taken to the Payment page and shown a summary of the certificates and their associated

surcharges, penalties, and credits. To continue with paying click the Make Payment button.

Please note the section in red on the screen. There is a due date before you will need to start the processes of adding

certificates to a payment again. If you click Pay Later you will need to use the Search Payments feature to find the

payment again. The payment will only be able to be found before the due date.

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Step 4

Please select the type of payment you are making; current payment methods will only accept Mastercard, Visa or Echeck.

For added security, enter account information by using the number pad to the right. If you have current available credit, it

will appear on this page. You may choose to use all or a portion of the credit balance by entering the amount in the Amount

to Apply field.

Click Continue to Proceed.

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Step 5A – Credit Card

Verify that all information is correct and click Next.

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Step 5B – Credit Card

Carefully enter the credit card information that you would like to charge the payment to.

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Step 5C – Credit Card

Verify all the information and correct as needed. To finish click the Submit Payment button.

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Step 5D - eCheck

Confirm if the payment is from a foreign bank or not and click Next.

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Step 5E – eCheck

Verify that all information is correct and click Next.

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Step 5F – eCheck

Carefully enter in the information for using your check and click the Next button.

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Step 5G – eCheck

To submit the payment, you will need to read the Terms and Conditions and in the process scroll all the way down to

the bottom of the Terms and Conditions before checking the Yes checkbox. After checking the Yes checkbox, you can

click Submit Payment.

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Step 6

After clicking Submit Payment button a please wait dialog box will appear. During this time your payment is being

processed. Do not close the tab or window and do not use the Back button now.

Once the payment has completed you will receive and email from [email protected] with the new

Payment ID. You should use this Payment ID to use the Search Payments feature to check on the certificates you just

paid for.

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Step 7

After a successful payment, you will see this screen. You can review what was entered for the payment as well as

the Payment Order ID aka Payment Order Number The time for processing will vary depending upon the

number of certificates that were submitted for payment.

You may now click Back to Dashboard to proceed with additional options.

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View Previous Fillings

Click Continue under View Previous Filings on the Dashboard to proceed.

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Step 1

You may search by a previously submitted certificate by entering information into the search fields. Your

search will be narrowed by entering as much information into as many fields as you can. The Certificate

Confirmation Number was provided via email when the certificate was previously submitted.

Click Submit to proceed.

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Step 2

Certificates previously submitted will appear in a list. By clicking the box to the left of the certificate, you may

view all information by clicking on View. If the certificate does not appear on this page, click next or previous

to see more certificates.

You may also export an individual certificate or select all to export all certificates to a .PDF report.

If you would like to go back, click Back to Dashboard or the Back button.

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Search Payments

Click Continue under View Previous Filings on the Dashboard to proceed.

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Step 1

To find payments enter information to filter down results. You may either search by the Payment ID or the Create Date

of the payment.

Click Search to continue.

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Step 2

After clicking Search the results will display in a grid below. From here you can click View to view the payment and

the certificates in the payment.

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Step 3

The certificates and their confirmations will display in a grid. A summary of the Surcharges, Penalties, and Credits will

display below. You can also click View to view the certificate in further detail.

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Credits and Reports

Click Continue under Credits and Reports on the Dashboard to proceed.

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Step 1

Any credits that are available to use will be shown on this page in The Total Credit Available. You may use any part

of or all of this amount when making payments during the Checkout Process and entering the amount in the Amount to

Apply field.

To find credits you will need to specify a start and end date for your search.

Click Search to continue.

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Step 2

By searching you can view the certificates or IDOI applied credits.

Click Back to Dashboard to continue.

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Admin Management

Click Continue under Admin Management on the Dashboard to proceed

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Creating a User

Admin Management allows the designated user(s) to manage all other users for this account. You may add, view,

or delete users, or edit current users and billing information. You may also upgrade your account to an Unlimited

Subscription in this section.

To create a user, click New User.

WARNING: Deleted users cannot be retrieved and must be re-entered.

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Step 1

Choose the role carefully as the role will determine what the user will be able to do. After choosing the role fill

out the rest of the information and certify by checking the checkbox. Once the Continue button has been hit the

user will be created and an email will be received by the specified email.

To continue click Continue.

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Bulk Submission

Click Continue under Bulk Submission to continue.

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Step 1

You will need to accept the statement on the screen before continuing to the Bulk Submission feature.

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Step 2

Before you upload you will need to make sure that you have the current template for bulk uploading. To see the current

template for upload, click Link to file format. Note that on the first sheet of the spreadsheet are some additional

directions.

Click Choose File to continue.

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Step 3

After clicking Choose File your browser will open a dialog box to choose a file to upload from your computer. If you

need help finding your file please contact your local administrator for assistance.

After selecting your file, click Open to continue.

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Step 4

The file name you selected will show next to the Choose File button.

Click Upload to continue.

Step 5

After clicking Upload a dialog box will appear for you to confirm.

Click Submit to continue.

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Step 6

After clicking Submit the file will start to upload. Note that you should not press the back button, close the tab, or close

the browser during this time.

After it is done it will proceeded automatically.

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Step 7

After processing the Bulk Upload will lead you back to the Bulk Submission File Upload page with a message depicting

the results of the upload.

A successful upload will need further processing, however in the meantime the upload can be viewed using the Bulk

Search feature with a status of New.

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Step 8

After the Bulk Submission Upload finishes processing its status will update from pending. At that time, you

will receive an email with an update on the upload. All successfully uploaded certificates will be added to a

payment that can be found via the Payment Search feature.

Any certificates that had errors can be viewed and corrected in the Bulk Search feature.

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Bulk Search

Click Continue under Bulk Search to continue.

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Step 1

To find your Bulk Submissions you can see all by clicking Search. To filter down results, enter in the status, upload

dates, or the Bulk Submission ID.

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Step 2

The results will show in a grid. The details tab will show an over view of the results of the upload. If the Bulk

Submission has been processed it will show a different status that New.

To view the records in the upload, click View.

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Step 3

Each record will have its own status. When reviewing the records, you can delete any records that you would no longer

like to be a part of the upload. Note that any records deleted will not be able to be recovered.

Failed records can be corrected by using the Edit link under the Options column.

Click Search Certificates to filter by status and then click Submit to filter.

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Step 4

The failure reason for the certificate will display in red at the top and corrections will be needed to continue.

All fields are required except for the Date Surcharge Received From The Provider and D.B.A.’s. If adding a

D.B.A. type in the name and either click Add or highlight the name and click Remove Selected.

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An ISO Code may only contain five numbers.

Health Care Provider Name should be the full legal name of provider. When editing an individual’s name, please enter

in the following format: John E. Doe (First/Middle/Last)

D.B.A. - You may enter as many D.B.A.’s as needed, but you must enter them one at a time, and then click Add. You

may also remove a d.b.a. from the list by selecting the name of the d.b.a. and then click Remove Selected.

EIN / Medical License Number may be edited on this page. PLEASE BE AWARE that modifying an EIN or License

Number will not update the Agency website. Please contact [email protected] to request this change be made to the

Indiana Patient’s Compensation Fund database.

Policy Number may contain numbers or letters. Type of Policy must be selected. When choosing a claim made or

reporting endorsement, a retro date must be entered. The retro date is the date of the first claims made policy with

the Indiana Patient’s Compensation Fund. This date might be different from the underlying retro date. If the

underlying policy is an occurrence policy, no other date is required.

Coverage dates – enter the policy effective dates. Dates may not exceed one year, except for reporting endorsements. If

entering coverage dates less than a year, you will be asked to verify later if this is a Pro- Rated or Locum Tenen policy.

Start coverage date may not exceed 180 days of the date certificate is submitted. If the coverage dates are between 91

and 180 days late from the policy effective date, the certificate will require agency verification. Information will be

saved on the electronic filing system, but will not be processed until approved by the IDOI. Please submit an Appeal

Letter and No Known Claims Loss Letter directly to [email protected] for approval. You may also use this email

address if you have further questions regarding the appeal procedure. Once the filing is approved or denied, you will be

notified whether to proceed with payment of surcharge and penalties.

Date Surcharge Received from the Provider – this is an optional field. It is the date that surcharge was received by the

carrier from the provider.

Minimum Occurrence Limits of Liability will fill out automatically to attempt to correspond with current statues. This

field cannot have a lesser amount, but the minimum occurrence limit of liability may be a greater amount. Minimum

Aggregate Limits of Liability is will be auto filled to correspond with current statues. The minimum aggregate limit of

liability may be higher depending on the type of provider, such as for a Nursing Home or Hospital. If the actual limits

of liability are greater than the minimum requirements, then those limits must be entered. It is your responsibility to

make sure the limits are entered in properly.

Premium Amount field is not required for hospitals and nursing homes. All other provider types must have amount

entered in this field, even if the carrier has not charged the provider a premium for the policy. In this case, you may

enter 0.

Click Continue to proceed.

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Step 5

At this point you will continue to make corrections as needed.

Credit selection is a required field. By default, the system selects I have no credits. Please verify that this is the correct

selection before proceeding.

If you have previously entered pro-rated coverage dates, then you will be asked to verify if this is a Pro-Rated or

Locum Tenen policy.

Click the Continue button to proceed.

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Step 6

Please verify that all information is accurate and then click Submit. If there are any errors, please click the

Back button and correct.

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Step 7

After submitting the record will process again. If the process is successful, you will be taken to the Manage Certificates

page. Here you will be able to move the certificate though as though it were not a Bulk Submission.


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