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Elizabeth M. Whitehorn, Director

Provider Notice Issued 10/13/2020

Date:    October 13, 2020

 

To:       Participating Hospitals:  Chief Executive Officers; Chief Financial Officers; and Patient Accounts Managers

 

Re:      Change in Billing Instructions for COVID-19 Related Long Term Acute Care Hospital Claims for Certain Non-Citizens

 

 

 

 

This notice provides revised billing instructions regarding COVID-19 related long term acute care (LTAC) hospital services for non-citizens ineligible for Medicaid due to immigration status.

 

In the August 19, 2020 provider notice, the Department notified providers that certification of admission and continued stay review requirements would be suspended for LTAC COVID-19 claims for this specific population and that system programming to bypass the eQHealth Solutions utilization review requirements would be implemented. It further instructed LTAC providers to hold claims for this population of patients until programming was complete.

 

The Department has decided not to change the programming to allow the claims to bypass the edit. Instead, LTAC providers are instructed to submit paper claims containing a COVID-19 diagnosis code directly to the Department and request an A88/C88 override. Once received, the claims will be submitted into processing with an A88/C88 override. Claims must be received within the timely filing limit of 180 days from the date of service. 

 

Providers are instructed to submit the paper UB-04 claim form with a copy of the UB-04 Override Request Form, HFS 1624A. These claims will be processed as a priority. Claims should be mailed to:

 

Illinois Department of Healthcare and Family Services

P.O. Box 19128

Springfield, IL  62794-9128

 

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565. 

 

 

Kelly Cunningham

Interim Medicaid Administrator