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August 2026
Back to Health: Your August Billing Digest
As summer winds down and families prepare for a new school year, August is a great time to refocus on preventive care, annual exams, and staying connected to important health services. This month’s digest highlights important billing guidance, payer updates, compliance reminders, and educational opportunities to help providers stay informed and prepared. Whether reviewing new requirements, keeping up with payer changes, or connecting patients with the care and resources they need, these updates are here to help your organization stay on track as we head into a busy fall season.
Aetna Better Health of Illinois
Aetna Better Health of Illinois: New Availity® Connection to EviCore
Beginning September 19, 2026, Aetna Better Health of Illinois will add a “Take me to EviCore” button within the Availity® Provider Portal’s “Is Authorization Required” feature. When EviCore manages the authorization, providers will be able to move directly from Availity to the EviCore portal through single sign-on, with member and service information transferring automatically. Providers will need both an Availity and EviCore account to use this feature. Click here to review the provider notice.
Blue Cross Blue Shield of Illinois
Encourage Routine Vaccines and Well-Care Visits for Children and Adolescents
Blue Cross Blue Shield of Illinois is reminding providers to encourage families to schedule routine vaccinations and annual well-care visits for children and adolescents. Providers are encouraged to identify members who are overdue for preventive visits or immunizations, assess vaccination status during visits, and ensure well-care visits and immunizations are properly documented. These efforts can help close care gaps and support Healthcare Effectiveness Data and Information Set (HEDIS) quality measures for children and adolescents. Click here for additional information and resources.
Blue Cross Blue Shield of Illinois: Post-Payment Reviews on Medicaid Claims
Beginning October 2, 2026, Blue Cross Blue Shield of Illinois will conduct post-payment reviews of Medicaid claims to verify billing, coding, and documentation accuracy. Providers selected for review may receive a written request for records and supporting documentation. Providers are encouraged to review their billing and documentation practices now to help ensure claims are accurate and properly supported. Click here for additional information.
Meridian is reminding providers that Illinois legislation now requires all Medicaid-enrolled children to receive blood lead testing at 12 and 24 months of age, regardless of where they live. Catch-up testing is also required for children up to age 7 who do not have a record of previous blood lead testing. Providers should document testing results in the medical record and submit claims using the appropriate billing code (CPT 83655). A risk assessment alone does not meet Medicaid EPSDT requirements. Click here to learn more.
Understand Upcoming Medicaid Policy Changes Affecting ACA Adults and Certain Immigrant Populations
Meridian is reminding providers about upcoming federal Medicaid policy changes that may affect certain members beginning October 1, 2026, and January 1, 2027. Beginning January 1, 2027, certain ACA Adult members will be subject to new work requirements and six-month eligibility renewals. HFS will begin mailing notices to affected ACA Adult enrollees on August 31, 2026. Additional changes affecting eligibility for certain immigrant populations will take effect October 1, 2026. Providers are encouraged to remind Meridian members to keep their contact information current with Illinois Department of Health and Family Services (HFS) and to respond promptly to all notices. Click here to see the provider’s notice.
CCBHC Billing Guideline Updates Rescinded
Molina Healthcare of Illinois has rescinded previously announced updates to billing guidelines for Certified Community Behavioral Health Clinic (CCBHC) and Community Mental Health Center (CMHC) services. The planned changes that were scheduled to take effect for claims received September 1, 2026, and forward will not be implemented at this time. Providers should continue following current billing guidelines until further notice. For additional information, please click here.
Aetna Better Health® of Illinois Provider Summit, August 27 | 1:00–3:00 PM CT
This virtual Provider Summit will provide updates on key topics including care management, quality, pharmacy, community outreach, value-added resources and benefits, the Availity® portal, value-based partnerships, claims, escalations, and required training. Click here to register.
Join the Illinois Public Health Association's Help. Guide. Thrive. Lunch & Learn Series for three (3) upcoming educational opportunities designed to support healthcare professionals and strengthen client-centered care:
Help Prevent RSV Lower Respiratory Tract Disease in Infants During Their First RSV Season, August 20 | 12:00–1:00 PM
This educational session will provide an overview of strategies to help prevent respiratory syncytial virus (RSV) lower respiratory tract disease in infants during their first RSV season. Participants will learn about current prevention recommendations and approaches to protecting infants from severe RSV illness. Click here for additional information and to register.
Grandparents for Vaccines: A Storytelling Movement to Protect Every Child’s Tomorrow, August 26 | 12:00–1:00 PM
This session will highlight the Grandparents for Vaccines storytelling movement and explore how personal stories and community voices can help build confidence in childhood immunizations. Participants will learn how grandparents and other trusted community members can play a role in supporting vaccination and protecting children from preventable diseases. Click here for additional information and to register.
Protecting Brain Health Through Food: Simple MIND Diet Nutrition Strategies for You and Your Community, August 28 | 12:00–1:00 PM
This session will explore practical nutrition strategies based on the MIND diet and how food choices can support brain health. Participants will learn simple, community-friendly strategies that can be incorporated into everyday life and shared with the individuals and communities they serve. Click here for additional information and to register.
Molina Healthcare of Illinois invites you to join the upcoming live webinars:
- CMHC/SUPR Town Hall, August 20, 1:00 PM Register
- Quality Improvement, HEDIS, and More, August 24, 1:00 PM Register
- Dental Provider Training, August 27, 11:00 AM Register
- CCBHC Program in Medicaid, September 2, 2:00 PM Register
- Provider Orientation, September 3, 2:00 PM Register
- Doula Billing, September 8, 1:00 PM Register
- Meet Your Dedicated Support Team, September 9, 2:00 PM Register
- Avoiding Common Denials, September 15, 1:00 PM, Register
- Physician Billing, September 16, 1:00 PM Register
- FIDE D-SNP Plan, September 17, 2:00 PM Register
- FQHC, RHC Encounter Clinic Billing, September 24, 1:00 PM Register
Looking for additional sessions? Explore the full 2026 schedule of live webinars exclusively for Illinois providers and register for provider updates to receive notices for upcoming trainings.
Aetna Better Health of Illinois
Aetna Better Health® of Illinois is committed to supporting providers with claims-related issues during the redetermination process. This support includes assistance with claims submissions for members during their redetermination window. Click here to see the provider notice.
The Summer 2026 newsletter is now available here.
Contact your Provider Relations representative with any questions.
BlueCross BlueShield of Illinois
The August 2026 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.
Humana is inviting Illinois providers and community partners to participate in its “Humana Is Listening” campaign. The brief survey is designed to gather feedback from those working directly with members and communities and will help inform how Humana prioritizes programs and services across Illinois. Providers are encouraged to share their feedback by Friday, August 28, 2026. Click here to complete the survey.
The Q3 2026 issue of Humana Physician News is available here. If you have not already subscribed to receive publications from Humana, you may sign up here.
Humana’s Medicare Stars Learning team is pleased to offer a series of live, facilitated educational sessions throughout 2026 to help providers stay informed and up to date. Click here to learn more and register.
The “Monthly Provider Check-In” for August 2026 can be found here.
Join Meridian’s live monthly session to stay informed on the latest updates for providers. Click here to register for the next live session on September 8, 2026.
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 Healthcare of Illinois is inviting randomly selected providers to participate in its 2026 Provider Satisfaction Survey. The anonymous survey, administered by Press Ganey, gives providers an opportunity to share feedback about their experience with Molina and help identify opportunities to improve administrative processes, operations, and the overall provider experience. Selected providers will receive a survey packet by mail and may respond by mail or online using the QR code included in the packet. Click here for additional information.
Molina is sharing a summary of recent news pertinent to your practice/facility.
Memo topics include: Rate/Fee Schedule updates for August 2026, 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.
Click here to receive information curated exclusively for Molina’s Illinois providers.
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 August 2026 issue of Network News contains important notifications and updates for healthcare providers.
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.
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!
