Provider Notice Issued 05/07/2020

Date:    May 7, 2020
To:       Enrolled Hospitals:  Chief Executive Officer; Chief Financial Officers; and Patient Accounts Managers
Re:      Hospital Submission of Duplicative Paper Claims
This notice serves to inform providers of the appropriate paper claim submission process for claims that require special handling by HFS staff.
By informational notice dated October 17, 2019, the Department stated only paper claims requiring an attachment for processing would be accepted beginning November 1, 2019. All other claims should be submitted via electronic methods.
·         If a paper claim with a required attachment can simply be put into processing, do not automatically send it to the attention of agency billing consultant staff for special handling. This only lengthens the processing time for the claim.
·         Claims that do require special handling should be accompanied by an HFS 1624A,
UB-04 Override Request Form that clearly identifies the special processing need, plus any supporting documentation regarding the request.
If a claim requires certain edits to be overridden by agency staff in order to process, providers should attach the HFS 1624A that identifies the specific reasons for the override request. Please refrain from automatically submitting the same paper claims monthly or at other periodic intervals. These additional and unnecessary paper claims only delay the manual review process.
Paper Claim Mailing Addresses
UB-04 Claims With Attachments
UB-04 Claims Requiring Special Handling by a Billing Consultant
Illinois Department of Healthcare and Family Services
UB-04 Inpatient/Outpatient Invoices
P.O. Box 19133
Springfield, Illinois 62794-9133
Illinois Department of Healthcare and Family Services
Bureau of Hospital and Provider Services
P.O. Box 19128
Springfield, Illinois 62794-9128
Questions regarding this notice may be directed to the Bureau of Hospital and Provider Services at 877-782-5565.
Kelly Cunningham
Interim Medicaid Administrator



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