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Provider Notice Issued 11/07/2019
Date: November 7, 2019
To: All Medical Assistance Program Providers
Re: UPDATE: New Sections Published under the Comprehensive Billing Guide for Medicaid Managed Care Services
The Illinois Medicaid Managed Care Organizations (MCOs), in collaboration with the Illinois Association of Medicaid Health Plans (IAMHP), have developed a Comprehensive Billing Guide for Medical Assistance Program providers. This billing guide is designed to help providers who are contracted with the MCOs understand the general MCO billing requirements.
MCOs have different policies and procedures related to billing. With this manual, the MCOs have created a single source of information for all claims regardless of provider type.
As different sections of the Comprehensive Billing Guide are finalized and published, the Department will update providers via a provider notice by listing the new sections. Updates and revisions will be provided quarterly, or more frequently if required. The Guide now has published information on:
· Hospice
· Federally Qualified Health Centers, Rural Health Clinics, and Encounter Rate Clinics
· Pediatric Services
· Community Based Behavioral Health Services
· Tubal Ligation and Hysterectomy Memo and Forms - Appendix F
Updated Sections in the Billing Guide include:
· Inpatient Hospital
· Claims Disposition
The guide is posted on the IAMHP website
For general questions or feedback regarding the Comprehensive Billing Guide, please contact IAMHP
Questions regarding this notice may be directed to the Bureau of Managed Care at 217-524-7478 or the individual HealthChoice Illinois managed care plan.
Robert Mendonsa
Deputy Administrator, Care Coordination