Date: September 25, 2020
To: Enrolled Federally Qualified Health Centers, Hospitals, and Laboratories
Re: Lab Testing and Claims Submittal Related to COVID-19
This notice provides updated information to that communicated in the July 17, 2020 provider notice regarding the Department’s upcoming deployment of an online portal that will allow providers to bill for COVID-19 testing services for patients. This billing guidance is effective with dates of service beginning March 18, 2020 and applies to claims for participants covered under traditional Medicaid fee-for-service and uninsured patients who have been tested for COVID-19. Providers should use the HRSA COVID-19 Claims Reimbursement Portal to request reimbursement for COVID-19 testing and testing-related services with dates of service between February 4 and March 17, 2020. Claims for Medicaid managed care members should be billed to the appropriate managed care plan.
The Department continues to develop the system changes necessary to create an online portal that will accept patient information contained within an Excel file layout. This online portal will have the functionality to:
· Create a RIN only - Providers who want to generate their own claims can request the Department generate a Recipient Identification Number (RIN) only for the uninsured COVID-19 testing patients.
· Create both a RIN and Claim - The full functionality of the portal will generate RINs and claims.
· Create a claim if a current RIN is found - If a RIN exists and the participant is eligible for traditional Medicaid without MCO enrollment, a claim will be generated. If the participant is eligible through a Medicaid managed care plan, the claim will reject and providers must bill the plan.
The portal functionality will allow the Department to generate non-institutional claims for hospitals, even if the date of service is on or after July 1, 2020, when hospitals transitioned to all-institutional billing.
In preparation to use the portal as soon as it is launched, providers are encouraged to take the following steps in advance to prepare for its use:
1) Enroll through the Department’s IMPACT system. Providers must be enrolled with the Department to be reimbursed.
2) A public domain Illinois.GOV e-mail address will be required to login to the upcoming COVID-19 testing portal. Providers must create an account at the Illinois.GOV website.
3) Prepare data for upload through the HFS COVID-19 testing portal.
· Detailed file requirements are attached.
· A sample Excel file layout is attached.
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 1-877-782-5565.
Interim Medicaid Administrator