· Managed care provides services for clients statewide, reaching approximately 80% of Medicaid enrollees
· Uniform credentialing process makes it easy for providers to enroll. There do not need to credential separately through each plan individually. Providers only need to credential once through IMPACT.
For more on these and other benefits, see the “Succeeding with the new Managed Care Program” notices. Strategies to help clients transition to HealthChoice Illinois are also included.
What are the goals of HFS’s HealthChoice Illinois program?
· Streamline managed care programs and reduce confusion for enrollees and providers by offering the information needed to make smart health care choices
· Increase integration of behavioral and physical health
· Provide a health plan and primary care provider (PCP) for every client
· Offer Care Coordination to help clients with complex needs navigate the health care system
· Align State and MCO objectives to enhance quality and improve outcomes
How and why should a provider participate in HealthChoice Illinois?
Contracting with health plans allows providers to continue serving existing patients throughout the transition and beyond. To contract with a health plan, providers should contact the plan directly to speak about qualifications or contractual agreements. HFS built HealthChoice Illinois after listening to the concerns and suggestions of providers like you. Smarter and more efficient than ever, we think you’ll discover the new program significantly reduces administrative requirements -- so you can focus on client care.
What are additional resources I can use to understand and navigate my way through the many aspects of HealthChoice Illinois?
In addition to the links at the right, more resources can be found on the provider page of the Illinois Association of Medicaid Health Plans (IAMHP) at http://www.iamhp.net/providers.
WellCare Health Plans, the company that owns Harmony Health Plan of Illinois, has purchased Meridian Health Plan of Illinois
Is Harmony Health Plan still an option for Illinois Medicaid members in HealthChoice Illinois?
As of January 1, 2019 Harmony Health Plan merged with Meridian Health Plan of Illinois. After January 1st, Harmony will no longer provide services to members.
What will happen to members who were enrolled in Harmony Health Plan?
Unless members change to a different health plan, Meridian will provide services beginning January 1, 2019. To stay in Meridian, members do not have to do anything at all.
Will members be able to keep their primary care provider (PCP)?
Meridian will make every effort to keep members with the same Primary Care Provider (PCP). If a member wants to change their PCP, they may do so at any time by calling Meridian Member Services at 1-866-606-3700 (TTY: 711) after December 31, 2018
What plan will providers call for billing inquiries?
Billing inquiries for dates of service before January 1, 2019, provider should contact Harmony Health Plan 1-800-608-8158
Billing inquiries for dates of service after January 1, 2018, providers should contact Meridian, a WellCare Company 1-866-606-3700