Provider Notice issued 09/04/12

Drug Prior Approval/Refill Too Soon Entry System

To:​ Participating Physicians, Dentists, Podiatrists, Optometrists, Advance Practice Nurses, Federally Qualified Health Center (FQHC), Encounter Rate Clinic (ERC), Rural Health Clinic (RHC), Family Planning Clinics, Community Mental Health Providers, Hospitals, Pharmacies, State Operated Facilities and Department of Alcohol and Substance Abuse Providers
​Date: ​September 4, 2012
​Re: Drug Prior Approval/Refill Too Soon Entry System​

The Illinois Department of Healthcare and Family Services is pleased to announce a web based Drug Prior Approval/Refill Too Soon Entry System through our Medical Electronic Data Interchange (MEDI) System. This feature allows providers to submit drug prior approval and refill too soon requests directly to the department electronically. In addition, providers will be able to use this system to check the disposition of their requests.

Electronic submission via the department’s MEDI System is available to enrolled providers and their authorized staff, claim submitting agents and payees. Providers who are not currently enrolled in the MEDI System will need to access the MEDI System and complete the registration process.

Providers registered in the MEDI System should have the Drug Prior Approval/Refill Too Soon Entry System available on the MEDI Home Page. Providers may begin submitting requests online as soon as the application is available on their MEDI Home Page. Each successful submission will be assigned a confirmation number. Providers are encouraged to print the confirmation page or write the number down. The confirmation number will be the only way a provider will be able to check the disposition of their request.

Providers who have successfully completed MEDI registration, but do not have access to this application will need to contact the MEDI Helpdesk at 1-800-366-8768 for assistance.

Providers are encouraged to enter prior approval requests using the MEDI System. In addition to MEDI, providers may submit requests to the department by telephone at 1-800-252-8942, or by fax to 217-524-7264 or 217-524-0404.

Questions regarding this notice may be directed to one of the following areas for assistance.

Registration Assistance, Digital Certificate/Password Reset and Administration/biller authorization

  • CMS Help Desk: 800-366-8768, option 1, option 3

Authentication error (non-password), Upload batch and 824 and 997 assistance

  • EDI Help Desk: 217-524-3814

Assistance in entering prior approval data or billing questions

  • Billing Consultants: 1-877-782-5565, option 7

Theresa A. Eagleson, Administrator

Division of Medical Programs