Agencies
Services
Provider Notice issued 07/15/11
Transition of Mental Health Billing to HFS
To: |
Community Mental Health Providers |
Date: |
July 15, 2011 |
Re: |
Transition of Mental Health Billing to HFS |
In accordance with Public Act 096-1405, the Department of Healthcare and Family Services (HFS), in collaboration with the Department of Human Services, Division of Mental Health (DHS/DMH), is preparing to support the direct billing of services provided by community mental health (CMH) providers to HFS beginning with claims submitted on or after July 1, 2011. To support this transition, the departments have prepared several tools and aids to assist providers with their billing. These tools are detailed below along with instructions for accessing the information.
Dedicated Web Page for Community Mental Health Centers
HFS has established a dedicated page for Community Mental Health Centers located on the HFS Web site at http://www.illinois.gov/hfs/MedicalProviders/behavioral/CommunityMentalHealthCenter/Pages/default.aspx. This part of the HFS Web site will provide access and links to support materials that CMH providers will find useful throughout the transition of billing activities to HFS. CMH providers should check the Community Mental Health Centers Web page regularly for updates, as information will be posted as it is available.
HFS Billing Manuals
HFS maintains multiple provider manuals that can be accessed via the HFS Web site. All CMH providers should ensure that all necessary personnel are familiar with these materials, as needed.
Chapter 100
Chapter 100 contains general policy, procedures and appendices applicable to all participating providers.
Chapter 300
Chapter 300 is a supplement to the X12 4010A1 and 5010 Implementation Guides and contains the companion guides for all providers who will be submitting X12 electronic transactions to the department.
Enhanced Community Mental Health Services Definition and Reimbursement Guide
The departments have updated the Community Mental Health Service Definition and Reimbursement Guide. This version of the Reimbursement Guide contains detailed information and instructions for submitting bills directly to HFS for reimbursement and highlights updates or changes to coding requirements resulting from this transition. Providers are encouraged to download the latest version of the Reimbursement Guide and identify coding changes that may affect their internal billing/coding systems and make all necessary changes to ensure successful reimbursement efforts when billing HFS for services.
Technical Assistance Teleconferences
To assist with the transition in billing, HFS will sponsor a series of teleconferences to address outstanding questions. The details for registering and a schedule of teleconferences will be posted on the CMH Web page.
Targeted Mailing Regarding National Provider Identification (NPI) Number
HFS will review CMH provider enrollment and will systematically identify providers that have failed to indentify a unique, one-to-one relationship between NPIs and HFS provider numbers. This correspondence will provide information to the provider regarding action to ensure that they do not experience billing rejections due to a failure to comply with department policy. All providers, even those not receiving correspondence on this matter, should carefully review their NPI records and HFS Provider Information Sheets and ensure that they have complied with the HFS Policies regarding NPIs for both provider numbers and payee numbers. Please refer to the November 15, 2010, notice located on the HFS Web site.
Dedicated Billing Support
The department has dedicated internal billing support staff to ensure that questions and concerns related to submission of bills to HFS are addressed. These resources can be accessed by dialing the HFS Provider Billing Line at 1-877-782-5565. Please choose Option 0 and request a Community Mental Health Support representative.
Theresa Eagleson, Administrator HFS, Division of Medical Programs
Lorrie Rickman-Jones, Ph.D., Director DHS, Division of Mental Health