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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 12/08/2017

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Date:       December 8, 2017

 

To:          Participating Pharmacies, Physicians, Dentists, Podiatrists, Optometrists, Hospitals, Advanced Practice Nurses, and Physician Assistants

 

Re:          POS Version D.0. Payor Sheet Update

 

 

This notice informs providers that the Illinois Department of Healthcare and Family Services has updated valid entries for two fields on the POS Version D.0. Payor Sheet effective immediately. 

 

The following two fields should only be used when submitting a 72-hour emergency fill request:

 

Field 461-EU: Prior Authorization Type Code

Field 462-EV: Prior Authorization Number Submitted

 

When a 72-hour emergency fill is being requested, enter the “value” field as follows:

 

Field #

Value

461-EU

2

462-EV

72

 

Any other values entered for these codes will result in a rejected claim.

 

An updated payor sheet can be found on the Department’s Payor Sheet webpage.

Questions regarding this informational notice should be directed to a pharmacy billing consultant in the Bureau of Professional and Ancillary Services at 877-782-5565.

 

Felicia F. Norwood

Director