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Elizabeth M. Whitehorn, Director

Provider Notice issued 10/29/15

Pay-To Provider (Payee) Billing Changes for Handbook for Hospital Services

To:​ Participating Hospitals: Chief Executive Officers, Chief Financial Officers, Patient Accounts Managers; and Renal Dialysis Providers​
Date:​ October 29, 2010​
Re:​ Pay-To Provider (Payee) Billing Changes for Handbook for Hospital Services​

The department has updated billing instructions for paper UB-04 inpatient, outpatient, and renal dialysis claims, to conform to new billing requirements related to the Pay-To Provider (Payee) in Form Locator 2.

Per the department's Informational Notice dated April 28, 2010, (Elimination of the One-Digit Payee Code) effective with claims received on and after October 1, 2010, providers must utilize the Pay-to Provider NPI. The department will no longer accept the one-digit payee code to designate the appropriate payee. Providers should use the billing guidelines in the Handbook for Hospitals Services, Appendix H-2, in conjunction with the UB-04 Data Specifications Manual. To become a UB-04 Subscriber, refer to the National Uniform Billing Committee (NUBC) Web site.

Appendix H-2 in the Handbook for Hospital Services has been updated and is available on the department's Web site. Printed copies of this bulletin and replacement pages for the handbook are available upon written request. To ensure delivery, specify a physical street address when making a request for a paper copy. Submit your written request or fax to:

Illinois Department of Healthcare and Family Services

Provider Participation Unit

Post Office Box 19114

Springfield, Illinois 62794-9114

Fax Number (217) 557-8800

E-mail the Provider Participation Unit

Any questions regarding this bulletin should be directed to your facility's medical assistance consultant in the Bureau of Comprehensive Health Services at 1-877-782-5565.

Instructions for updating the Handbook for Hospital Services:

Remove Appendix pages H-2a (1); H-2b (1); and H-2c (1) and insert updated pages H-2a (1); H-2b (1); and H-2c (1) with revision date October 2010.