Why join HealthChoice Illinois

Simpler and smarter. More resources for you and those you care for.

We understand that Medicaid can be a challenge for providers. We know you take part because you realize it’s right for your patients and clients.

We built HealthChoice Illinois – the enhanced approach to Medicaid managed care – to help reduce the time you spend on administration and offer you more resources to provide the care you’re committed to.

When managed care started in Illinois, there were dozens of health plans providers had to interact with. The reboot of managed care included robust standards to ensure that every health plan would have the capability to provide effective care. And we chose an optimal number of plans. Now there are seven select and certified health plans (https://www.hfs.illinois.gov/healthchoice/providercontacts.html) to partner with. That means less hassle and better service for you to partner with. That means less hassle and better service for you.

Health plans offer their members experienced professionals and a team framework to help make sure the right care is being provided. For providers, this means an added voice and support to assist with patients and clients. For high-risk members, this can be especially beneficial.

Simplified and single credentialing eliminates the need to be separately credentialed by every health plan before contracting with them. Under the rebooted program, as soon as providers are approved by IMPACT – the HFS Provider Enrollment System – you’re cleared to contract with every health plan without additional credentialing requirements. (Note: Providers should continue to offer other information requested by health plans that needed for processing.)

Special needs children, including those receiving SSI and children in the Medically Fragile Technology Dependent waiver, and youth in DCFS care, were included in the managed care reboot strategy. That means all the advantages of HealthChoice Illinois are available to them. Beginning in 2018, managed care also expanded statewide.

By being part of as many health plans as you can, you’ll help make sure your patients and clients can continue getting care from you without interruption or other challenges.

We’re “partnering for performance” – working with the health plans to offer tools to help providers better understand and treat their patients and clients. These data-based strategies give you extra resources and opportunities. More than ever, we’re measuring outcomes and monitoring performance to help the people we serve make smart healthcare decisions.

New online tools such as the Integrated Eligibility System (IES) mean members can better access their own eligibility and health plan enrollment information for less confusion among your patients and clients. 

An online health-plan-specific quality report card helps members make smart health plan choices, which means better informed patients and clients.

To help members and other participants better understand and use the benefits of HealthChoice Illinois, HFS and the health plans are teaming up to create joint awareness projects. With help from providers and community partners too, we’re working to amplify the messages on prevention, early intervention, care coordination and more.