Date: September 10, 2018
To: Participating Community Mental Health Centers
Re: Removal of DHS Social Services – Special Eligibility Segment Requirement Effective October 1, 2017
The purpose of this notice is to update Community Mental Health Centers regarding adjudication of claims and system programming related to Department of Human Services (DHS) Social Services – Special Eligibility Segment, also known as Social Service Package B.
For dates of service on or after October 1, 2017, Community Mental Health Center claim adjudication no longer requires DHS Social Services – Special Eligibility Segment on the recipient file.
For dates of service on or before September 30, 2017, the recipient file must contain the DHS Social Services – Special Eligibility Segment.
Providers should verify participant eligibility via MEDI, the Automated Voice Response System (AVRS) at 1-800-842-1461, or through a REV vendor. Providers should contact DHS at DHS.ERIN@ILLINOIS.GOV if a participant file is missing this eligibility package in error.
Healthcare and Family Services (HFS) will notify providers when DHS Social Services – Special Eligibility Segment system programming is completed. Providers requiring a manual time override for claims that could not be submitted timely due to the Illinois Eligibility System (IES) transition should contact a Healthcare and Family Services (HFS) Community Mental Health Billing Consultant at 877-782-5565. Claims may be eligible for an override of the 180 days from date of service submittal timeframe if received by HFS within 180 days of the date of HFS notification to providers of data system updates that allow claims to be accepted.
Questions regarding this notice should be directed to a Community Mental Health Billing Consultant in the Bureau of Professional and Ancillary Services at 877-782-5565, options 1, 2, 4, and 8.
Teresa T. Hursey