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Provider Notice Issued 05/10/2018
Date: May 10, 2018
To: All Medical Assistance Providers
Re: Medicare-Medicaid Alignment Initiative (MMAI) Simplified Credentialing
This notice informs providers that the single and simplified credentialing process established by the Department of Healthcare and Family Services (HFS) for HealthChoice Illinois is expanding to include the Medicare-Medicaid Alignment Initiative (MMAI) plans.
Currently, providers must become credentialed with each MMAI health plan they want to contract with separately, which creates an unnecessary burden on providers.
In an ongoing effort to streamline the enrollment and credentialing process, HFS is building on the credentialing policy established for HealthChoice Illinois. Effective immediately, Medicare and/or Medicaid providers will only need to register through the HFS Illinois Medicaid Program Advanced Cloud Technology (IMPACT) website for MMAI participation. Once an application is approved by HFS, the provider is considered credentialed with all MMAI health plans. Plans will not be allowed to require any additional credentialing.
Providers will continue to be required to provide specific information requested by Managed Care Organizations (MCOs) that is not included in the IMPACT credentialing process, but is needed for MCO Operations, such as provider office hours.
Medicare providers who choose not to register through the HFS IMPACT website will continue to be credentialed by the MMAI health plan prior to participation in the MMAI health plan’s network.
Additional information regarding MMAI may be found on the Department Website.
Questions regarding this notice may be directed to the Department’s Bureau of Managed Care at 217-524-7478 or HFS.MMAI@Illinois.gov.
Felicia F. Norwood
Director