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Elizabeth M. Whitehorn, Director

Provider Notice issued 04/19/05

Direct Data Entry Claim Submittal Available via the Internet

​To: ​Participating Medical Assistance Providers
​Date: ​April 19, 2005
​Re: ​Direct Data Entry Claim Submittal Available via the Internet

Effective March 21, 2005, the Illinois Department of Public Aid (IDPA) is pleased to announce the availability of electronic claim submission via the Internet for six claim formats. This new electronic feature allows you to submit claims directly to the department through your Internet browser software. No additional hardware or special software is needed.

 

The following claim formats will be accepted in the MEDI/IEC system as of March 21, 2005:

  • DPA 2360 - Health Insurance Claim Form

  • DPA 1443 - Provider Invoice

  • DPA 2209 - Transportation Invoice

  • DPA 2210 - Medical Equipment/Supplies Invoice

  • DPA 215 - Drug Invoice

  • UB92

The following claim formats are in the last phase of testing and will be available in the near future.

        • DPA 3797 - Medicare Crossover Invoice

        • DPA 2211 - Laboratory/Portable X-Ray Invoice

Electronic claim submission via the Internet is available by registering on the department’s Medical Electronic Data Interchange, Internet Electronic Claims (MEDI/IEC) System via the Internet at: <http://www.myhfs.illinois.gov/>. The MEDI/IEC System is available to enrolled providers and their authorized staff, claim submitting agents and payees. During the registration process, you will be given access to specific claim formats based upon your enrollment status with the department.

 

Through electronic claim submission, providers receive immediate feedback on many of the required field entries. In addition, a confirmation page is available to print on each successful submission of a claim. The confirmation page displays all of the fields that were entered on the claim submission, including date of submission, time of submission and confirmation number, which can be used for tracking purposes.

 

Please remember, providers wishing to receive e-mail notification, when new provider information has been posted by the department, may register at the following IDPA Web site:

 

 

If you have any questions regarding this notice, you may contact the Bureau of Comprehensive Health Services toll-free at 1-877-782-5565.

 

Anne Marie Murphy, Ph.D.
Administrator
Division of Medical Programs