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Enrollment in the Health Benefits for Immigrant Adults (HBIA) program will be temporarily paused effective July 1, 2023.

Enrollment in the Health Benefits for Immigrant Seniors (HBIS) program will be temporarily paused effective Nov. 6, 2023.

Elizabeth M. Whitehorn, Director

D17 Quantity Billed Requires Prior Approval

HFS System Issue:

DME claims with a maximum quantity allowed within a specific timeframe denied D17, Quantity Billed Requires Prior Approval.

Problem:

On 9/11/2014, the system was changed to manage the quantities for a group of supplies. The change affected all DME codes with quantity limitations.

Providers Impacted:

Durable Medical Equipment and Supplies Providers

Procedure Codes Impacted:

All DME HCPC codes that are coded PA Req: N and the Max Quan/ Days field is populated on the fee schedule which can be viewed at http://www.illinois.gov/hfs/MedicalProviders/MedicaidReimbursement/Pages/DME.aspx

Problem Begin Date:

Claims received on or after 9/11/14.

Problem Fix Date:

10/1/14

Resolution for Impacted Claims:

Providers must rebill.