|
Dear Colleagues,
The Illinois Department of Healthcare
and Family Services (HFS) has indicated to us that they are receiving
many claims that have been submitted with a Group NPI number as the
Billing Provider instead of an individual NPI number as the Billing
Provider. HFS cannot process a claim submitted with a Group NPI as the
Billing Provider. Since many of these claims do not contain the
provider's HFS number, there is no way for the claims to be processed
and no way for HFS to identify or notify the correct Billing Provider.
The HFS policy for using the NPI numbers for billing does NOT match the
CMS policy and this has generated a great deal of confusion. However,
claims for Illinois Medicaid clients must follow the HFS policy or they
cannot be processed. Illinois Health Connect is working to educate
providers about this situation. Please disseminate the attached info to
your members as this has impacted many providers in Illinois and
prevented their claims from being processed. Thank you.
Regards,
Margaret Kirkegaard
Margaret Kirkegaard, MD, MPH
Medical Director, Illinois Health Connect
Automated Health Systems
1375 East Woodfield Road, Suite 600
Schaumburg, IL 60173
email: mkirkegaard@automated-health.com
cell: 630-991-6665
phone: 888-912-9120 x2218
fax: 847-995-1021
National
Provider Identifier Implementation
FAQ Document
In order to assist PCP offices with educating patients about
using their selected/assigned medical home, AHS has prepared an educational letter that can
be distributed to patients who present to the wrong PCP office for care. The letter is
available on the Illinois Health Connect website under the Client Materials section.
http://www.illinoishealthconnect.com/clientmaterials.aspx
Offices can download the letter, print it on office letterhead and give it to patients who
are not registered to that office. Please assist us by informing your members that this
letter is now available for use. |
