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  • Medicaid Provider Alert: Provider revalidation has begun and those not completing the process risk disenrollment.  Check your account now to learn when your revalidation is due. More information here.
Elizabeth M. Whitehorn, Director

Provider Notice issued 12/30/14

New Web Based Application to Update or Change Enrollment Information for Currently Enrolled Providers

 

​To: Participating Medical Assistance Program Providers​
Date:​ ​December 30, 2014
​Re: New Web Based Application to Update or Change Enrollment Information for Currently Enrolled Providers​

 

 

 

The purpose of this informational notice is to alert currently-enrolled providers of the new online application available on the Department of Healthcare and Family Services (HFS) General Provider Enrollment Requirements webpage. The application will make provider enrollment and claim services more cost effective, efficient and convenient for our Medical Programs providers. Effective immediately, the new application is available for providers to notify the department of updates or changes to their enrollment information via the on-line application for the following categories:

  • National Provider Identifier (NPI)

  • Provider name

  • Provider demographic (address, phone, email)

  • Payee demographic (address, phone, email)

  • Add a payee

  • Close a payee

  • Close enrollment

  • License

  • Clinical Laboratory Improvements Amendments (CLIA)

The department appreciates your participation in the Illinois Medical Assistance Program. Any questions regarding this notice may be directed to the Provider Participation Unit at 1-877-782-5565.

 

James M. Parker, Acting Administrator

Division of Medical Programs