Illinois association publishes billing guide for Medicaid managed care

An Illinois organization has published a billing guide designed to reduce claim denials in state Medicaid managed care, according to Crain's Chicago Business.

The manual comes from the Illinois Association of Medicaid Health Plans, a member organization that represents the state's Medicaid managed care insurers.

The association said the manual aims to help support and direct contracted Medicaid managed care providers on billing for services to Medicaid patients.  

It applies to HealthChoice Illinois managed care organizations and for services provided to Medicaid beneficiaries in Medicaid-only programs. However, it does not apply to those in the Medicare Medicaid Alignment Initiative program who are dually-eligible.

"The manual gives providers a one-stop document for billing and claims procedures, without having to look up each health plan and/or provider-specific process separately," the association wrote in the guide. "IAMHP completed a thorough review and comparison of all member MCO billing guides, and working closely with our members, has crafted a single source for all claims policies and procedures, regardless of provider type."

The association expects to provide manual updates and revisions to providers at least quarterly.


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