![]() Tickets that are submitted in the new portal on or after will be processed under the new resolution process and applicable timeframes for submitting, monitoring, and resolving disputes between a provider and an MCO, as required by Public Act 101-0209 (SB1321). For existing open tickets, HFS will work to resolve them with the providers and MCOs expeditiously under the current process. Beginning , HFS will suspend/stop receiving complaints in the current portal. The link to the Resolution Portal is found on HFS’ Care Coordination Webpage, or may be accessed directly from the HFS Managed Care Provider Resolution Webpage. ![]() Effective, all providers will now submit unresolved issues with an MCO via the new secure web-based Provider Resolution portal. This notice is second in a series of notices regarding the implementation of the new provider MCO resolution portal. Second Notice: New HFS Provider Resolution Process and Portal Effective ![]() If you receive claim rejections, the affected claims must be corrected and resubmitted with the needed information as specified in the rejection message.įind more information on this and more at. These responses will specify if additional data elements are necessary. Providers submitting these claims electronically on or after April 1, 2020, may see new edit messages on the response files from their practice management system or clearinghouse vendor(s) before the claim is adjudicated. New Electronic Commercial Claim Validation Edits, Effective April 1, 2020Īs of April 1, 2020, Blue Cross and Blue Shield of Illinois (BCBSIL) will implement new electronic claim submission validation edits for commercial Professional and Institutional claims (837P and 837I transactions).* These claim edits will be applied to claims during the pre-adjudication process to help increase efficiencies and to comply with Medicare data reporting requirements.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |