HFSMedical ProvidersMedical Provider Handbooks

Provider Handbooks

The intent of Provider handbooks is to furnish Medicaid providers with policies and procedures needed to receive reimbursement for covered services, funded or administered by the Illinois Department of Healthcare and Family Services, which are provided to eligible Illinois Medicaid participants. The handbooks provide detailed descriptions and instructions about covered services as well as billing instructions.

Providers are responsible for compliance with all policy and procedures contained herein.

Chapter 100 contains general policy, procedures and appendices applicable to all participating providers.

Chapter 200 contains specific policy, procedures and appendices applicable to the provision of a specific type of provider or category of service (specialty/subspecialty).

Chapter 300 - Companion Guide  Information contained in Chapter 300 is a supplement to the X12 (5010) or NCPDP (5.1 or 1.1 batch) Implementation Guides. This handbook contains the companion guides for all providers who will be submitting X12 or NCPDP electronic transactions to the department.

Managed Care Manual - This manual contains helpful information regarding the Medicaid managed care program for providers enrolled in Medicaid.

Additional Resources for Providers


Medical Provider Handbooks

 

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