Provider Types

The

is a reference guide that provides important information for providers enrolling or revalidating via IMPACT – both for providers that only deliver services through the HFS Medical Programs, as well as waiver program providers that deliver services for one or more other funding agencies (DHS, DCFS, IDoA, DSCC).

There are 11 tabs on the workbook:

• The first tab (labeled IMPACT) provides comprehensive critical information for enrolling through IMPACT.
• The next 8 tabs (labeled by funding agency) contains information that helps providers translate terms between the language/categories used in IMPACT and the language/categories used by other funding agencies.
• The 10th tab (labeled instructions) contains definitions for many of the key terms and abbreviations.

Sorting and filtering options are available on each tab.

• Provider Type Name
• Locate your provider type for the services you provide. You can enroll as two different provider types, as long as they have the same enrollment type.
• Provider Type Specialty
• Select the specialties that apply to you.
• Provider Type Subspecialty
• A provider subspecialty is required. Select those that apply to the type of services you provide. For those that do not have a subspecialty, you will select the value "No Subspecialty"
• IMPACT Enrollment Type
• One of the first enrollment steps to complete based on your provider type. The necessary information is provided here.
• Screening Risk Level
• This provides what level of screening is involved with each provider type in order to give providers an idea on estimated processing times and/or additional information that might be required.  Additional information about screening risk levels is available in the Medical Provider Exclusion and Criminal History Background Check Screening document. 
• Licensing/Certificate
• These columns will provide what license and/or certificates are required to submit an enrollment application via IMPACT. If the required information is not entered, the system will not let the application be submitted.
• There are optional licensing and/or certificates that can also be entered to provide supplemental documentation electronically versus sending in via paper.
• Be aware this may not satisfy all required enrollment information to be provided; refer to the provider enrollment instructions from your funding agency/agencies for any information that may need to be submitted outside of IMPACT.

These tabs provide the same information listed above, as well as:  including also:

• Agency Services mapped to IMPACT terms – this provides a crosswalk if a provider is associated to an additional funding agency to show how they need to enroll (i.e., provider type/specialty/subspecialty) in IMPACT.
• Date of IMPACT – with the expansion of provider enrollment, for each agency there are some providers that may not be required to enroll until January 2016. Providers can use this column as a starting point and reach out to their specific funding agency for additional information.