Skip to main content
  • 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 08/04/2023

 

Date: August 4, 2023 
​To: Participating Hospitals:  Chief Executive Officers, Chief Financial Officers; and Patient Accounts 
​Re:  Hospital Outpatient Claims for Fee-for-Service Sexual Assault Treatment Services Now Billable

This notice informs hospitals that the Illinois Department of Healthcare and Family Services (HFS) has completed claim processing system updates regarding the minimum $1,000.00 payment of sexual assault outpatient hospital treatment services in accordance with Public Act 102-0699. This system update applies to claims billed under HFS’ fee-for-service (FFS) program.

By provider notice dated July 5, 2022, HFS provided specific billing guidance and asked hospitals to hold applicable electronic FFS claims for Medicaid-eligible FFS sexual assault survivors until notified that system pricing updates had been completed. Hospitals may now submit these electronic claims for dates of service retroactive to July 1, 2022, within 180 days of the date of this notice.  

A 1624A, UB-04 Override Request Form, must be attached to any claim that does not meet HFS’ timely filing requirements. Submitters are asked to note, “Due to Forensic Services”, on the 1624A to assist HFS staff in processing these claims.

For the MCO-covered population, hospitals should contact the appropriate HealthChoice Illinois MCO (HCI MCO) for specific billing information.

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for FFS claims or to the applicable HCI MCO plan.

Kelly Cunningham, Administrator
Division of Medical Programs