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Elizabeth M. Whitehorn, Director

Provider Notice issued 02/05/04

Handbook for Providers of Medical Services, Chapter 100-General Policy and Procedures January 2004 Update

To:​ All Enrolled Providers​
Date:​ February 5, 2004​
Re:​ Handbook for Providers of Medical Services, Chapter 100-General Policy and Procedures January 2004 Update​

No. Ch100-04-1

The purpose of this bulletin is to inform providers of an updated appendix and new appendix regarding Third Party Liability/Coordination of Benefits (TPL/COB) for Chapter 100-General Policy and Procedures. These appendices are available on the department's Web site at: <http://www.illinois.gov/hfs/MedicalProviders/Handbooks/Pages/Chapter100.aspx>.

All providers submitting claims in the HIPAA NCPDP version 5.1 format for products with a National Drug Code (NDC) designation should reference the Handbook for Electronic Processing, Topic 304 (NCPDP) for changes to topic 304.5 (Third Party Liability). These changes give specific guidance for the billing of TPL/COB data. Also reference the Handbook for Electronic Processing, Appendix 2 (Provider Payor Sheets for NCPDP version 5.1 ECP Input Transactions). These documents are available on the department's Web site at <http://www.illinois.gov/hfs/MedicalProviders/Handbooks/Pages/Chapter300.aspx>.

It is the responsibility of each provider to ensure that all material related to changes in the department's billing procedures, handbooks, etc are shared with their software vendor, corporate help desk or information systems area.

If you do not have access to the Internet, or need a paper copy, printed copies are available upon written request. You need to specify a physical street address to ensure delivery. Submit your written request or fax to:

Illinois Department of Public Aid

Provider Participation Unit

Post Office Box 19114

Springfield, Illinois 62794-9114

Fax Number: 217-557-8800

E-mail address is hfs.webmaster@illinois.gov

This Provider Bulletin lists the pages to be removed and replaced.

Instructions for Updating Handbook

General Appendix 9 Third Party Liability Resource Code Directory

Remove the entire appendix dated November 2000 and insert new appendix dated January 2004.

General Appendix 14 TPL/PBM Resource Code Directory

Insert new appendix dated January 2004.

If you have any questions regarding this bulletin, please contact the Bureau of Comprehensive Health Services at 217-782-5565.