Notices and Newsletters

2024 Newsletters:

 

Fall 2024 Newsletter (PDF)

 

Summer 2024 Newsletter (PDF)

 

Spring 2024 Newsletter (PDF)

 

Winter 2024 Newsletter (PDF)

 

 

2023 Newsletters:

 

Fall 2023 Newsletter (PDF)

 

Summer 2023 Newsletter (PDF)

 

Spring 2023 Newsletter (PDF)

 

Winter 2023 Newsletter (PDF)

 

 

2022 Newsletters:

 

Fall 2022 Newsletter (PDF)

 

Summer 2022 Newsletter (PDF)

 

Winter 2022 Newsletter (PDF)

 

 

2021 Newsletters:

 

Fall 2021 Newsletter (PDF)

 

Spring/Summer 2021 Newsletter (PDF)

 

Winter 2021 Newsletter (PDF)

October 2024
 

HCBS waiver training registration (PDF)

 

Aetna and Quest Analytics Partnership (PDF)
 

Edifecs CRA for missing diagnosis codes (PDF)

 

 

September 2024

 

 

H2015 and H2016 code limitations (PDF)

 

CLIA certificate on laboratory claims (PDF)

 

EFT/ERA registration vendor services (PDF)

 

 

August 2024

 

Policy update effective 10/1/24: Drugs and Biologicals (PDF)

 

ORP denials (PDF)

 

Provider revalidation requirement (PDF)

 

Policy update effective 10/1/24 (PDF)

 

Provider Summits September 2024 (PDF)

 

 

June 2024

 

ECHO Health electronic payment system (PDF)

 

 

May 2024 

 

Provider Summits June 2024 (PDF)

 

2024 Provider Satisfaction Survey (PDF)

 

 

April 2024

 

Policy updates effective 6/1/2024 (PDF)

 

Update on Change Healthcare: Recoupment resumption (PDF)

 

Policy updates effective 6/1/24 (PDF)

 

Update on Change Healthcare outage 4/3/24

 

 

March 2024

 

Update on Change Healthcare outage 3/25/24 (PDF)

 

Measles resources for providers (PDF)

 

Medicaid precertification optimization (PDF)

 

Policy updates effective 6/1/24 (PDF)

 

 

February 2024 

 

Change Healthcare outage (PDF)

 

Durable medical equipment verification and authorization (PDF)

 

HCBS waiver reminders (PDF)

 

 

January 2024 

 

Register for our 2024 Provider Summits (PDF)

 

Redetermination claims process (PDF)

 

Clinical, payment and coding policy changes (PDF)

 

 

December 2023

 

2024 Pay for Performance program (PDF)

 

UPDATED: HBIA/HBIS member population effective 1/1/24 (PDF)

 

Payment of claims related to hysterectomy and sterilization claims (PDF)

 

New Medicaid claims and encounters front end edits (PDF)

 

 

November 2023

 

Hospice nursing home room and board adjustments and repayment sunset (PDF)

 

 

September 2023

 

ESRD claims denials (PDF)

 

Clinical payment, coding and policy changes: Q3 2023 NPP Review (PDF)

 

Clinical payment, coding and policy changes: Q3 2023 PUR Review (PDF)

 

 

August 2023

 

1135 Waiver bulletin (PDF)

 

PT44 configuration (PDF)

 

 

June 2023

 

Itemized bill submission (PDF)

 

Monovalent COVID-19 vaccine codes (PDF)

 

E&M code denial error (PDF)

 

 

May 2023

 

Supplemental Data Exchange (PDF)

 

 

April 2023 

 

Clinical, payment and coding policy changes (PDF)

 

T1016 benefit limit (PDF)

 

 

March 2023 

 

Reconsideration tracking numbers in Availity (PDF)

 

Telehealth claims denials from local public health clinics (PDF)

 

 

February 2023

 

 

Age restriction rejection notice (PDF)

 

 

January 2023

 

Pathways to Success behavioral health program (PDF)

 

 

November 2022

 

Change in timeframe for grievance and appeal retro-authorization (PDF)

 

 

October 2022

 

Referring provider rejection notification (PDF)

 

COVID-19 treatment options letter from IDPH (PDF)

 

Hospice nursing home recoup and repayment (PDF)

 

 

September 2022

 

Claim denials and front-end rejections (PDF)

            

Long-Term Care Facilities telehealth originating site fee (PDF)

 

T2003 Billing Update (PDF)

 

Claims from Behavioral Health Clinics and Community Mental Health Centers (PDF)

 

 

August 2022

 

Out-of-network benefits notice (PDF)

 

 

July 2022

 

Policy updates: Clinical, payment and coding policy changes (PDF)

 

FAQ for SNIP Level 3 and 4 Edits (PDF)

 

Claims: Untimely submissions and mailing address (PDF)

 

 

June 2022

 

Precertification optimization effective 8/1/2022 (PDF)

 

Pediatric COVID vaccination (PDF)

 

Provider Education: Coding Validation (PDF)

 

 

April 2022

 

Medicaid precertification optimization notice (PDF)

 

SNIP Level Editing Notice (PDF)

 

2022 Medicaid Pay-for-Performance (P4P) Program (PDF)

 

 

March 2022

 

Outpatient Dialysis Provider Notice (PDF)

 

 

 

February 2022

 

March Vision Care Claims Address Change Notification (PDF)

 

 

January 2022

 

Provider Portal Sunset Delay Notice (PDF)

 

HEDIS Supplemental Data Channel Instructions (PDF)

 

 

December 2021

 

Resubmission of Misdirected Vision Claims Notice (PDF)

 

2022 NEXGEN Updates (PDF)

 

NEXGEN FAQs (PDF)

 

Pay for Performance Payout Information (PDF)

 

 

November 2021

 

Availity Reporting Capabilities Bulletin (PDF)

 

Availity MVP Sunset Notice (PDF)

 

Regulatory Compliance Addendum (PDF)

 

Telehealth Claims Notification (PDF)

 

 

October 2021

 

Provider Demographic Data Verification Notice (PDF)

 

Holiday Check Run Schedule Notification (PDF)

 

State Compliance Addendum (PDF)

 

Edit 915 Provider Notification (PDF)

 

 

August 2021

 

Follow Up After Hospitalization Measure Modifications for HEDIS (PDF)

 

 

July 2021

 

Historical IlliniCare Claims Run Out Notification (PDF)

 

Invalid Claim Denials Notification (PDF)

 

 

June 2021

 

Aetna Checks Returned Notification (PDF)

 

Availity Portal Information (PDF)

 

T1502 and T1019 PA Requirements (PDF)

 

H0039 PA Requirement (PDF)

 

Peer to Peer Policy (PDF)

 

 

May 2021

 

SCCP Announcement (PDF)

 

Claims Xten Buletin (PDF)

 

LTC 90 Day Max Benefit Denial Bulletin (PDF)

 

 

April 2021

 

Hospital Inpatient Reminder (PDF)

 

Long Term Care Biling Reminder (PDF)

 

Hospice Providers Reminder (PDF)

 

Pathology Denials (PDF)

 

Hospital Denials (PDF)

 

HCBS Waiver Providers Reminder (PDF)

 

BH Code Denials (PDF)

 

Availity Announcement (PDF)

 

March 2021

 

Resume Timely Bulletin (PDF)

 

H0047 Claims Denial Notification (PDF)

 

EOP Denial Ambulance H2H Transportation Claims Notification (PDF)

 

EOP Denial BH Claims Notification (PDF)

 

2021 Pay-for-Performance Program Details

 

 

February 2021

 

Diabetic Retinopathy Screening (PDF)

 

OB Ultrasound Policy Notification (PDF)

 

Cologuard Service Prior Authorization Notification (PDF)

 

 

January 2021

 

Notification on MLR Reporting (PDF)

 

Changes in Prior Authorization Requirements (PDF)

 

Correct BH Forms Notification (PDF)

 

Correct Prior Authorization Fax Number Notification (PDF)

 

 

December 2020

 

Changes to Encounter Clinic Billing Requirement (PDF)

 

Paper Claims Submission and Check Run Notification (PDF)

 

Correct Payer ID for Claim Submissions (PDF)

 

Prior Auth Training and Video (PDF)

 

Pharmacy Roster Rejects Notification (PDF)

 

Check Run Pay Dates Notification (PDF)

 

HFS Practitioner Fee Schedule Notification (PDF)

 

Prior Auth Delay Notification (PDF)

 

Welcome to ABH-IL Letter (PDF)

 

 

November 2020

 

Hospice Reminder (PDF)

 

 

August 2020

 

Invalid EXx8 Denial (PDF)

 

DRG Location (PDF)

 

Hospital to Hospital Billing (PDF)

 

 

May 2020

 

Electronic Claim Training (PDF)