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July 2025
Summer can be a busy time of year. Between work, vacations, outdoor fun, and preparations for Back- to-School and flu clinics, it’s easy to miss important updates. With that in mind, this month’s Digest is “beach-ready”— a bit slimmer and focused on “hot topics” and “cool trainings”. The Third-Party Billing Team at the Illinois Public Health Association (IPHA) wishes everyone a safe and fun summer. And don’t forget the sunscreen!
Health Alliance, the largest insurer in Central and Southern Illinois, will cease all health plans in Illinois, except for Medicare Advantage, at the end of 2025. Illinois Central Management Services published this Frequently Asked Questions document in March 2025. Individuals with Health Alliance plans on the Marketplace will have an opportunity to pick a health plan with a different insurer during open enrollment, which starts November 1. Additional information can be found here.
Molina Healthcare of Illinois debuted a new Availity Auto Auth Tool for Marketplace plans. Additional information can be found in the MHIL Provider Memo, July 2.
Illinois Department of Healthcare and Family Services (HFS) is hosting several Townhalls to assist Illinois providers with the revalidation process. The Federal Centers for Medicare and Medicaid Services (CMS) required all actively enrolled providers to renew their Medicaid provider agreement at least every five years. More information and dates for the Townhalls can be found here.
IPHA invites you to SAVE THE DATE ON Monday, August 4, from 1:30 PM-2:30 PM CT.
The IPHA Third-Party Billing Project, in collaboration with Meridian Health, will present “From Denials to Dollars: Meridian Billing Success for Local Health Departments”. This webinar will be led by Angela Jackson, Vice President, Provider Operations at Meridian Health, and will focus on understanding and addressing the most common billing denials local health departments experience from Meridian Health. Registration information will be sent soon!
National Association of County and City Health Officials (NACCHO) is hosting “Reimbursement 101: Understanding Coding and Billing for STI/HIV Services” on August 13 at 1:00 PM CST. Additional details and registration can be found here.
Blue Cross Blue Shield of Illinois invites contracted providers serving members in Blue Cross Community Health PlansSM and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM to register for a webinar series led by Merck & Co., Inc. on vaccine confidence and strategies.
- July 22 from noon to 12:45 PM CT, Strategies to Help Build Vaccine Confidence and Using Motivational Interviewing to Foster Chage. Register here.
- August 5 from noon to 12:45 PM CT, Scientific Insights: Measles, Mumps, Rubella, and Varicella and A Guide to Different Diagnosis: Selected Rash/Illness in Children Register here.
- August 19 from noon to 12:45 PM CT, Disease Burden from Diphtheria, Tetanus, Pertussis, Poliomyelitis, Invasive Haemophilus Influenzae type B and Hepatitis B and Invasive Pneumococcal Disease and Pediatric Population Health. Register here.
BlueCross BlueShield of Illinois
The July issue of Blue Review is available. 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 Q2 2025 issue of Humana Physician News is available here.
The Humana Gold-Plus Integrated provider manual, effective June 15 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.
June’s Monthly Provider Check-In can be found here.
Meridian town halls are back! Meridian is hosting in-person, town hall meetings throughout the state. This is an excellent opportunity to connect with Provider Relations, Claims, and Utilization Management teams; get questions answered and forge stronger relationships. Find the Townhall nearest you here.
Contact your organization's assigned Provider Engagement Administrator or representative for seamless support. For those without an assigned representative, please complete the intake form or contact them using the information below here.
MolinaPalooza is back and better than before! Providers and staff are invited for a day packed with learning and laughs, featuring your dedicated provider relations manager. Details and event registration can be found here.
Molina published the latest Rate/Fee updates on June 30. July Rate/Fee Schedule Updates, MHIL Provider Memo, Molina Healthcare of Illinois
The Second Quarter Provider Newsletter 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 July 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 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!
