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Provider Notice issued 07/06/2023
| Date: | July 6, 2023 |
| To: | Enrolled Physicians; Advanced Practice Nurses; Physician Assistants; Federally Qualified Health Centers; Rural Health Clinics; Encounter Rate Clinics; Local Health Departments; Hospitals; School-Based/Linked Health Centers; Independent Laboratories; and Home Health Agencies |
| Re: | COVID-19 Uninsured Population with No Social Security Numbers – Payment Process |
This notice advises providers regarding a special claim payment process for COVID-19 services rendered to uninsured individuals for whom no Social Security Number (SSN) could be determined, and therefore no recipient identification number (RIN) could be authorized through the COVID-19 Uninsured Portal.
The Department of Healthcare and Family Services (HFS) has developed a file format for providers to identify unpaid COVID-19 services for the uninsured population for whom no SSN could be determined. The file information includes an attestation that the provider has performed due diligence in determining the patient does not already possess a Recipient Identification Number (RIN), have other insurance, or an SSN.
Providers are asked to start preparing claim information using the file format linked below for unpaid COVID-19 services, but only after thorough review and eligibility verification attempts confirm the patient has not previously been assigned a RIN, has no other insurance coverage, and has no known SSN. Providers will have a one-time opportunity to submit files beginning September 1, 2023, through October 31, 2023. Providers must include all of their unpaid services in a single file submittal, with one provider number reported per file. HFS has set up the following email address for providers to submit their files:
HFS.NIPS.C19Uninsured@Illinois.gov
All records for the uninsured population must contain a diagnosis code indicating the patient encounter was for the purposes of COVID testing, COVID vaccine administration, and/or COVID medication treatment. Records with no COVID or COVID-related diagnosis code will not be paid.
HFS will be conducting random verification of claims data received and will be working with the HFS Office of Inspector General (OIG) to notify them of irregularities.
HFS will make a one-time payment per provider for the services submitted via a C-13 payment voucher outside of the normal claim processing system.
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565.
Kelly Cunningham, Administrator
Division of Medical Programs