May, 2025

Third-Party Billing Information and Resources at Your Fingertips

During the month of April, IPHA hosted three regional third-party billing forums. These forums were facilitated with funding from IPHA’s Third-Party Billing contract with Illinois Department of Public Health (IDPH). Each forum began with a discussion of billing best practices and strategies to maximize revenue. Then, representatives from each MCO provided vital information and resources for providers. Each forum ended with an update about the funding provided by IDPH to help public health departments and community-based organizations implement an electronic health record that is fully integrated with billing and Revenue Cycle Management (RCM) services. The presentation slides and other materials from all three forums are now available at IPHA’s Third-Party Billing webpage.

In addition to the materials presented at each forum, this webpage has links to the recordings and slides for past webinars and trainings. Infographics have recently been added for several trainings; providing a helpful summary of the materials covered.

IPHA’s Community-Based Organization (CBO) Clinical Services Expansion Playbook is also posted on this webpage. This free guide helps CBOs prepare for the implementation of electronic health records, third-party billing, and revenue cycle management (RCM).   

Past issues of IPHA’s monthly Billing Digest are also archived on this page. Each issue of the Billing Digest is packed with links to essential information and resources pertinent to billing and RCM procedures.

This website is updated monthly, so bookmark this site and visit frequently to find more helpful tools!

Summits, Town Halls, “Paloozas”, and Conferences

More Opportunities to Network and Learn

The months ahead include several valuable training and networking opportunities. Mark your calendars, and don’t miss these important events:

Aetna Better Health of Illinois (ABHIL) Provider Summit: The ABHIL Provider Experience team will host a virtual summit on May 22, 1:00 – 3:00 PM. Topics to be covered include Care Management, Claims, Escalations, Quality, Community Outreach, and more. For additional information, please see this notice. To register, click here.

Meridian Town Hall Meetings: Following the success of their 2024 town hall events, Meridian is kicking off a series of seven town hall meetings for providers. Each town hall meeting will provide opportunities to meet Meridian’s management team, learn more about Meridian & YouthCare, share feedback, and strengthen partnerships. The schedule is as follows:

• June 2, 11:00 AM – 1:00 PM, Oak Brook, IL
• June 11, 8:00 AM – 10:00 AM, Rockford, IL
• June 25, 8:00 AM – 10:00 AM, Rock Island, IL
• July 10, 11:00 AM – 1:00 PM, Peoria, IL
• July 16, 11:00 AM – 1:00 PM, Springfield, IL
• July 29, 8:00 AM – 10:00 AM, Champaign, IL
• August 13, 11:00 AM – 1:00 PM, Mount Vernon, IL

For more details and registration links, please click here.

MolinaPalooza Provider Days ‘25: Molina Healthcare of Illinois invites providers and staff for a “day packed with learning and laughs, featuring your dedicated provider relations managers.” MolinaPalooza will include trainings, networking opportunities, vendor exhibits, lunch, and a tour of the Molina Mobile Help Center. “You have two opportunities to join the fiesta that is MolinaPaooza 2.0.”

• June 27, 10:00 AM – 3:00 PM, Oak Brook, IL
• August 29, 10:00 AM – 3:00 PM, Springfield, IL

Visit here to learn more. Click here to reserve your seat.

IL Rural Health Educational Conference: The Illinois Rural Health Association will be hosting their 36^th Annual IL Rural Health Educational Conference July 30 – 31 at the I-Hotel in Champaign. This year’s conference includes sessions about RHC Billing, RHC Compliance, Maximizing Reimbursements, RHC Revenue Cycles, and more. To see the full conference agenda, click here. You may register here.

2025 Annual IAMHP Conference: The Illinois Association of Medicaid Health Plans (IAMHP) will be hosting their Annual Conference October 27 – 28 at the Hilton Chicago/Oak Brook Hills Resort and Conference Center. This conference convenes Medicaid providers, managed care organizations (MCOs), state officials, business vendors, and community partners from throughout Illinois. It is an excellent opportunity to learn more about Illinois Medicaid programs and to network with key personnel from all Illinois Medicaid MCOs. Click here to register.

IPHA 84^th Annual Public Health Workforce Conference: This year, IPHA is excited to premiere a larger, combined event that joins the IPHA Annual Meeting with our CHW Summit. On September 9 – 11, 2025, this joint conference will gather community health workers, public health professionals, students, educators, state officials, and partners from all sectors of Illinois’ public health community to meet at the Bloomington-Normal Marriott Hotel and Conference Center to learn, network, and explore opportunities for collaboration. IFLOSS has also partnered with IPHA on this event. So, it will truly include the full spectrum of Illinois’ public health workforce. To learn more, please visit the conference webpage. Early bird registration is now open.

Upcoming Trainings

The Illinois Association of Medicaid Health Plans (IAMHP) will be presenting the following trainings:

• June 18, 12:00 – 1:00 PM CST, Lunch & Learn webinar, Utilization Management.
• July 3, 12:00 – 12:45 PM CST, Sip & Refresh webinar, Universal Roster Billing.
• July 17, 12:00 – 1:00 PM CST, Lunch & Learn webinar, Primary Care Billing.

Aetna Better Health of IL (ABHIL)

Please review the ABHIL Spring Newsletter.

The next ABHIL New Provider Orientation Trainings will be held Wednesday, May 21, 12:00 PM – 1:00 PM and Wednesday, June 8, 12:00 PM – 1:00 PM.  To register, please click here.

To help support Home and Community-Based Services (HCBS) Waiver providers, ABHIL has launched their Waiver Services Resources and FAQs page and Waiver Services Billing page.

The ABHIL Provider Experience team will be hosting a training session on Tuesday, June 10, 12:00 – 1:00 PM to help educate providers about the HCBS Waiver program. Topics to be covered include:

• HFS Waiver programs
• Transportation billing
• Home Modification billing
• Rejections and denials

You may register for this training here.

BlueCross BlueShield of Illinois

The May issue of Blue Review is available here. If you have not already subscribed to receive this publication, you may sign up here.  

For a complete list of upcoming Webinars and Workshops, click here.

Free Coding Webinars: The BCBSIL Medicare Advantage Coding Compliance team offers webinars on documentation standards and general coding requirements. These webinars are available to providers and coding professionals. Each course offers one continuing education credit from the American Academy of Professional Coders (AAPC). The sessions include information on ICD-10-CM guidelines, sample coding case studies and tips on closing gaps in care. Click here for a complete schedule and registration.

Humana

The Q2 2025 issue of Humana Physician News is available here.

Humana’s Making it Easier Tutorials are a library of self-paced guides and tip sheets created to make it easier for Providers to do business with Humana. You can search by categorized topics to learn about Authorizations, Claims, Billin and Coding, Modifiers, and more.

Meridian

April’s Monthly Provider Check-In can be found here.

Meridian has published an Availity Essentials Transition Update regarding claims corrections, Remittance Viewer, PCP notifications, and more.

For a complete list of upcoming webinars, please see Meridian’s 2025 Quarterly Webinar Schedule.

Molina

The Molina Provider Relations Team has issued their Monthly Memo Roundup.

Molina has recently published a Provider Memo with information and registration links for webinars and trainings provided this month. For the remainder of this year, please see their 2025 Provider Education Series.

United Healthcare

The May issue of Network News contains important notifications and updates for UHC 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.   

To help decrease the potential for claim denials, UHC offers a comprehensive series of free coding trainings and resources. Visit Coding Corner to learn more. 

The Centers for Medicare and Medicaid Services (CMS) Medicare Learning Network (MLN) has issued an important notification pertaining to Part B preventive vaccine updates that will be going into effect as of July 1, 2025 for Rural Health Clinics and FQHCs. You can view the notification here.

HFS has recently issued several important Provider Notices:

• Update – New Sections Published Under the Comprehensive Billing Manual for Medicaid Managed Care Services
• Update – School Based/Linked Health Center Fee Schedule
• Update – LPHA Fee Schedule
• Update – Practitioner Fee Schedule
• Update – Family Planning Fee Schedule
• Reissue – Dental Office Reference Manual
• Resuming Pharmacy Prior Authorization System
• Health Benefits for Immigrant Adults (HBIA) – Notice of Coverage Ending Effective June 30, 2025
• Initiation of Buprenorphine – Medication for Treatment of Opioid Use Disorder (MOUD)
• Updates to the Illinois Medicaid Crisis Assessment Tool (IM-CAT)
• Introduction of Electronic Clinical Review Platform for Managing Prior Authorizations for Adaptive Behavioral Support (ABS) Services

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.