January Lunch & Learn

28 Jan 2021 4:00 PM | IAMHP Support (Administrator)

January Lunch & Learn Blog

The new year is such an important time for us to invest in ourselves, and that includes taking time to invest in our work skills and knowledge. We here at the Illinois Association of Medicaid Health Plans (IAMHP) want to help you start your year strong so we can all achieve better health care outcomes for Illinois residents this year.

That is why we brought you our latest Lunch & Learn training!

IAMHP hopes our January 2021 Lunch & Learn on the Illinois Medicaid Program Advanced Cloud Technology (IMPACT), our Comprehensive Billing Guide, and IAMHP Resources give you some new information that can help you this year.

This webinar was designed to provide guidance to contracted Medicaid providers who are responsible for billing services but is open to anyone who wants to learn more about the Medicaid program in Illinois or who want to learn more about MCOs and IAMHP.

To view our January Lunch & Learn visit the IAMHP video library or check out our question & answers to catch the highlights from the webinar!

Question: Approximately how long does it take the Department of Healthcare and Family Services (HFS) to review IMPACT information once it has been submitted?

Answer: As of January 20, 2021, if it is not a COVID-19 related application it takes approximately 30 to 45 days.

Q: Does HFS notify an MCO once a provider has been enrolled in IMPACT?

A: MCO can become aware or notified that a provider been approved and enrolled in IMPACT on a weekly extract file that is sent directly to an MCO. Weekly extract files are typically sent to health plans on Wednesday afternoon. Please note, there are a couple of technical processes that happen on the HFS side that can potentially create a little lag time between when a provider may get approved on IMPACT and when that information flows over to the health plans. Generally, HFS hopes to minimize that lag to a weeks’ time.

Q: Once a provider has been enrolled in IMPACT does the provider receive a notification?

A: Yes, once a provider is approved, they will receive a notification. Generally, a provider will receive a series of systematically generated emails once they start the application process. First, a provider will a generated email after they apply which will have basic information such as their application ID. Second, a provider will receive an email informing them that their application was approved. Third, a provider will receive an email 14 to 30 days after the IMPACT application has been approved with a generated provider information sheet.

Q: How should a health care facility remove a provider that is no longer associated with the health care facility?

A: The preferred and recommended course of action is to send an email to impact.help@illinois.gov requesting for that provider to be end dated. This ensures HFS is updating records accordingly. It should be noted, that a provider can also do this through the modification process.

Q: Can providers check in IMPACT to ensure they are enrolled before prescribing medication to a Medicaid member?

A: HFS implemented a provider directory on the HFS website specifically for the ordering referring and prescribing providers.

The information contained in this directory is made available to the public by HFS to assist Medical providers in verifying an actively enrolled ordering/referring/prescribing Medicaid provider. This directory is provided for informational purposes solely regarding a provider's enrollment and is not intended to guarantee payment for any service by any provider.

Q: Where there any complications with IMPACT during the third quarter of 2020? What measures are being taken to minimize complications moving forward?

A: The beginning of September of last year (2020), HFS was notified of some issues with their licenser interface. As a result of, providers who became inactive due to expiration of licenser were no longer enrolled in IMPACT. Once aware of the issue, HFS worked with their vendor to ensure that those interfaces are working.

There was a bit of an alarm again in the end of November and beginning of December when thousands of providers again became inactive due to licensure. It should be noted that many providers who licensure became inactive is because some providers licenses were extended due to the COVID pandemic.

HFS worked with IDFPR to try to get an extension for those licenses but the extension was not granted. IDFPR has to manually review every license application again and make that license active, due to short staffing this process can take time. HFS believes the last round of applications have been corrected. 

HFS has tested the licensure interface and believes this process is now working. Nevertheless, these are interfaces we collectively rely on. When glitches to arise and HFS is made aware of these, HFS commits to working collaboratively with the vendor to ensuring those get resolved.

Collaboration with partners like IDFPR and feedback from providers and the MCOs are crucial when complications arise, or system/interface breakdowns potentially occur. HFS encourages providers and provider associations reach out to HFS so they can be made aware when those system issues might arise.

HFS has taken steps to ensure they stay on top of the feedback and stay on top of their processes. There are internal workgroups at HFS and workgroups between HFS and the MCOs specifically dedicated on provider enrollment. The workgroups plan on continuing to meet regularly.

There are also monthly HFS / IAMHP / MCO and Provider Association Meetings to discuss billing conversations and technical issues that arise.

The collective encourages you to utilize the tools available to you!

Learn about the latest news & insights on Illinois Medicaid for healthcare providers and healthcare advocacy groups by visiting our website IAMHP.net.

And like and follow us on Facebook, LinkedIn and Twitter.

If you are interested in becoming a Trusted Partner, I encourage you reach out to Alaina Kennedy at alaina@iamhpteam.net or visit our website at IAMHP.net.

As part of being a Trusted Partner you actually have the opportunity to attend all of our Lunch & Learns for complimentary, among many more benefits.








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