We’re glad you’re in the Network

Encore is the health network that cares. We provide access to doctors your patients know, and hospitals they trust


Encore Health Network reviews providers’ credentials at the time they apply for admission to the network, and every three years thereafter, to ensure credentialing standards are met. Among some of the details we review are:

  • Medical licenses
  • Training and board certification
  • Network hospital admitting privileges
  • Medical malpractice claims history

Credentialing for listed health care providers is verified with appropriate state and federal agencies and accrediting bodies. Final review and approval of a provider to the Encore Health Network is supported by a panel that includes doctors based in your own community.

Encore currently considers contracting and credentialing for individual MD, DO, DPM, DDS (oral & maxillofacial surgery only), DC, OD and Advanced Nursing Specialists (NP, CNS, CNM and CRNA), PA, PT and OT. Behavioral Health Practitioners; psychiatrists and physicians certified in addiction medicine, doctoral level Indiana practitioners licensed with HSPP designation, licensed clinical social workers, licensed marriage and family therapists, licensed mental health counselors, and other licensed independent practitioners listed in Encore literature for members. Any licensed medical or behavioral health professional must meet minimum credentialing criteria before consideration.

Council for Affordable Quality Healthcare (CAQH) Applications
Encore accepts paper copies of fully completed CAQH applications in lieu of our own. When applying as a new provider, please provide a copy of the full application along with all supporting documents and certificates.

Encore does not credential facility-based providers specializing in anesthesiology, emergency medicine, pathology, radiology and others who see members solely within an inpatient or facility setting. Further, Encore does not credential Maverest Dental providers, Healthyroads, EPIC or Vision Discount plan providers unless they are also listed as Participating Providers in the Encore Health Network.

*Credentialing guidelines are reviewed annually and are subject to change without notice.

Download Practitioner Credentialing Application
Indiana Application
Illinois Application
Kentucky Application
Ohio Application

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My Payor Download



If you have any questions, please contact webmaster@encoreconnect.com
Special Authorization is required to access the Payor Updates.
Please contact one of the following Account Executives for access:
· Holly Joyce at (317) 621-4263 or hjoyce@encoreppo.com, or
· Kevin McShay at (317) 621-4264 or kmcshay@encoreppo.com

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Notice

Encore has entered into a new arrangement for chiropractic services with HSM, Inc. HSM, Inc., a Minnesota-based specialty network services organization, will administer the chiropractic network for our Encore and Encircle service areas.

HSM will directly hold contracts with all participating chiropractors; therefore, there are some changes of which you should be aware. Regarding billing, chiropractors will now send their claims directly to HSM. HSM will collect the data in their system, including treatment plans for case management, and forward claims to the appropriate Encore payor. The payor will send all payment directly to HSM, who will in turn reimburse the chiropractor according to the negotiated rates.

If you are interested in becoming a participating chiropractor in the Encore Health Network, please contact HSM at 800-432-3640 or visit their web-site at www.hsminc.com.

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Current Worker's Comp Payors

Arete USA D/B/A The Covenant Companies
HealthSmart
HFN, Inc
Indiana University
InterPlan Health Group
IU Health Plan
MCMC LLC
ASU Group
Major Hospital
ACS CompIQ Corporation, A Xerox Company

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Payor and Provider Resources

Payors please contact Account Executive Kevin McShay at (317)621-4264 or kmcshay@encoreppo.com for access.

For any provider issue, please contact Provider Contracting Coordinator, Tina Bilodeau at (317)621-4269 or tbilodeau@encoreppo.com.