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Elizabeth M. Whitehorn, Director

Provider Notice issued 09/08/16

Introducing the ILLINOIS Rx Portal Website

To: Participating Pharmacies, Physicians, Dentists, Podiatrists, and Optometrists
Date: September 8, 2016
Re: Introducing the ILLINOIS Rx Portal Website

The Illinois Department of Healthcare and Family Services (HFS) is pleased to announce the launch of the ILLINOIS Rx Portal website, created to support the new Pharmacy Benefits Management System (PBMS) which will be online in 2017.

The PBMS is part of the new Medicaid Management Information System (MMIS) upgrade and will allow for faster and more efficient processing of pharmacy claims billed fee-for-service. This notice applies to participants enrolled in traditional fee-for-service and does not apply to Care Coordination and Managed Care Organizations (MCOs).  

The ILLINOIS Rx Portal provides a secure, web-based interface and allows providers to perform the following functions:

  • Submit Prior Authorization (PA) requests and upload any supplemental information needed.
  • View the status of submitted PAs, including reason for denial.
  • Look up participant eligibility, drug history and PA history.
  • Access the HFS drug formulary.
  • Submit non-Point of Sale (POS) claims and receive a real-time approval or denial notification.

 

Visit the ILLINOIS Rx Portal website to learn more about the new system including features, requirements for registration, frequently asked questions and training and webinar options. The Department will be updating this site frequently as the launch of the new PBMS gets closer. To stay updated on the new system, link to the Provider notices and bulletins website.

 

Felicia F. Norwood
Director