No images? Click here
September 2025
84th Annual Illinois Public Health Workforce Conference a Success!
The IPHA Annual Public Health Workforce Conference was a resounding success, bringing together professionals from across the state to share ideas, strategies, and innovations under the theme “Making Public Health an Illinois Priority.” Attendees engaged in thoughtful discussions, dynamic sessions, and collaborative networking that highlighted the dedication and strength of the public health workforce. The event not only celebrated progress but also reinforced a shared commitment to advancing health equity and ensuring public health remains at the forefront of Illinois’ priorities.
Several Illinois MCOs exhibited at the event, providing an opportunity for attendees to meet directly with representatives. Thank you to Aetna Better Health of Illinois, Blue Cross and Blue Shield of Illinois, Humana Health, Meridian Health Plan, and Molina for sharing your time and expertise with attendees!
If you could not attend this year’s conference, we hope you can join us next year. Plans are already underway for the 2026 IPHA Public Health Workforce Conference. Save the Date for September 1-3, 2026, in Springfield! Keep an eye on our Annual Conference webpage for updates.
Alert!
Blue Cross Blue Shield of Illinois has changed how claims are processed for members with Blue Cross Community Health Plans. Starting August 1, providers must use the new three-character prefix ‘XXL’ on claims and use Payer ID 66012 when submitting an electronic claim. The mailing address for paper claims with attachments has also changed. More information on this change can be found here.
Blue Cross Blue Shield of Illinois, on or after November 16, 2025, will update the Lyric software database to better align coding with the reimbursement of claim submissions for primary and secondary editing. Among the changes, the Sexually Transmitted Infection Multi-Code will be rebundled. You can find more details here: Five New Claims Editing Rules will be Implemented November 2025 | Blue Cross and Blue Shield of Illinois
Illinois Association of Medicaid Health Plans (IAMHP) will host the 2025 Annual IAMHP Conference Navigating Change October 27-28 in Oak Brook, Illinois. This event focuses on advancing innovation, equity, and quality in Medicaid. To learn more, or to register, Click Here.
Blue Cross Blue Shield of Illinois invites you to join the upcoming live webinars:
- Prenatal and Postpartum Care and Prenatal Depression Screening and Follow Up on November 4 from 12:00 to 12:30pm. Register Here.
- Live Provider Webinars on Upcoming DSNP Plan going into effect January 1, 2026. Details to register can be found here.
- Blue Cross Blue Shield of Illinois offers free webinars and workshops for contracted providers. A list of On Demand trainings and Upcoming webinars can be found here.
Molina Healthcare of Illinois invites you to join the upcoming live webinars:
- Doula Billing, Thursday, September 25, 1:00 pm. Register here.
- Lactation Consultant Billing, Thursday October 9, 1:00pm. Register here.
- Doula Billing, Monday, October 20, 1:00pm. Register here.
- Lactation Consultant Billing, Wednesday, November 5, 1:00pm. Register here.
- Doula Billing, Monday, November 17, 1:00pm. Register here.
- Lactation Consultant Billing, Thursday, December 11, 1:00pm. Register here.
- Doula Billing, Tuesday, December 16, 1:00pm. Register here.
- Live Provider Webinars on Upcoming DSNP Plan going into effect January 1, 2026. Details to register can be found here.
Looking for something else? Explore the 2025 schedule of live webinars exclusively for Illinois providers. Meanwhile, register for provider updates to receive notices for upcoming sessions.
Aetna Better Health of Illinois
The Summer Newsletter can be found here.
Contact your Provider Relations representative with any questions.
BlueCross BlueShield of Illinois
A few common billing errors typically cause most denials of claims for members of Blue Cross Community Health Plans. For resources to help your claims process more smoothly and avoid delays in payment for service dates prior to August 1, 2025, visit Avoid Many Denials of Medicaid Claims with Help from New Resources | Blue Cross and Blue Shield of Illinois
The September issue of Blue Review is available here. If you have not already subscribed to receive this publication, you may sign up here.
To contact your Provider Network Consultant, visit Provider Network Consultant Assignments for more information.
The Q3 2025 issue of Humana Physician News is available here. If you have not already subscribed to receive publications from Humana, you may sign up here.
The Humana Gold-Plus Integrated provider manual, effective June 15, 2025, can be found here.
Humana’s Resource Sheet for Healthcare Providers is a one-stop resource containing essential information on a variety of important topics for providers.
September’s Monthly Provider Check-In can be found here.
Meridian recently updated Resolving Common Claims Rejections, a resource providing tips on resolving and avoiding rejected claims.
Contact your assigned Provider Engagement Administrator or representative for support. For those without an assigned representative, complete this intake form or contact Meridian using the information here.
Molina is sharing a summary of recent news pertinent to your practice/facility. Memo topics include: Rate/Fee Schedule Updates for September, Updates to Molina Clinical Policies, and much more! You can find the ‘Memo Roundup’ here. To register for Illinois provider updates, so you don’t miss any bulletins, Click Here.
The Second Quarter Provider Newsletter, Illinois Edition, can be found here.
Contact your dedicated Provider Relations Manager or email the Provider Relations team at MHILProviderNetworkManagement@MolinaHealthcare.com. To help identify your dedicated Provider Relations Manager, visit Molina's Service Area map.
The September issue of Network News contains important notifications and updates for healthcare providers.
The September 2025 Reimbursement Policy Update can be found here.
The News Your Way feature allows you to customize your subscription to receive information and updates specific to your role, specialty, and state. Click here to subscribe or update your preferences.
Illinois Association of Medicaid Health Plans (IAMHP) released the Summer 2025 Newsletter. The issue is full of excellent information and topics, including a discussion on new Medicaid work requirements; a legislative session recap; and a Feature Article that focuses on the Impact of Federal Legislation, focusing on provider and MCO taxes.
Advanced MD provided a free billing guide for beginners, “Medical Billing for Private Practices: A Beginner’s Guide”. Get a copy of the free guide here.
HFS Updates:
Electronic Visit Verification (EVV) is a technology-based system that efficiently verifies home healthcare visits. EVV reduces the likelihood of error while promoting program integrity through practical and simple monitoring. There are a variety of ways to ensure you do not miss important updates or information:
- Sign up for Illinois Department of Healthcare and Family Services (HFS) EVV Provider Notices.
- Visit Illinois’ Electronic Visit Verification (EVV) website.
- The second quarterly EVV Townhall webinar is scheduled September 19, 2025 from 10:00am to 12:00pm CT Click this link to register.
Providers enrolled in the Ground Emergency Medical Transportation (GEMT) program are notified that payment for FY2025 Quarter 4 (4/1/2025-6/30/2025) will be due by October 31, 2025. Providers should request Form 3881 from HFS at HFS.GEMT@Illinois.gov. Questions may be directed to HFS.GEMT@illinois.gov or the Bureau of Professional and Ancillary Services at 877-782-5565.
Fee Schedule Update for School Based/Linked Health Center Fee Schedule was updated on August 29, 2025.
A complete list of HFS Provider Notices can be found here.
If you have not already subscribed to receive email notifications from HFS when new Provider Notices are posted, you may subscribe here. To learn more about the many helpful resources available to healthcare providers, please visit the HFS Provider website.
If you have not already subscribed to receive email notifications from HFS when new Provider Notices are posted, you may subscribe here. To learn more about the many helpful resources available to healthcare providers, please visit the HFS Provider website.
If you have any questions or suggestions for topics that you would like to see covered in future issues of the IPHA Billing Digest, please email your suggestions and/or requests to insurancebilling@ipha.com. Your feedback is valuable and appreciated.
Thank you!
