To: Participating Medical Assistance Providers
Re: New Enrollment System for the Illinois Medical Assistance Program – Billing Agents
Illinois Medicaid Program Advanced Cloud Technology (IMPACT)
The purpose of this
informational notice is
to
inform billing
agents that the State of Illinois
is launching a new enrollment process and computer system known as
Illinois Medicaid Program Advanced Cloud Technology
(IMPACT). Billing agents submitting electronic claims to Illinois
Medicaid and/or receiving electronic remittances will be required to access the IMPACT system and enroll beginning
July
20, 2015.
A
billing agent is defined as a business authorized to submit
Medicaid Health Insurance
Portability and Accountability Act (HIPAA)
compliant transactions or a business authorized to exchange Electronic Protected Health Information (ePHI) on behalf of a Medicaid provider
or other authorized party.
Billing agents are
referred to as Clearing Houses, Software
Vendors or
Value Added Networks
(VAN) depending on their relationship to the health care provider. Billing
agents do not render services directly to clients enrolled in the Medical Assistance
Program.
This is the first phase in replacing the current Medicaid Management Information System (MMIS). IMPACT is a web based system that will
be
accessed and used by all Medicaid providers,
waiver program
providers and
billing
agents doing business
with
the State of
Illinois. Billing
agent enrollment into the IMPACT system must
occur in the initial phase of the implementation of the IMPACT system so that associations may occur between billing agents, entities and individual providers. While billing/claiming processes will remain unchanged in 2015 and 2016, failure of a billing agent to enroll in the IMPACT system in a timely manner may lead to payment delays
for
those entities
or individual providers
who are in
need of associating to the billing agent.
As soon as the IMPACT provider
portal
is made available on-line (the go-live date), billing
agents will
have a two week
window in which the use of the system will primarily be dedicated to their enrollment. Outreach will
be
conducted during this time to
assist with the enrollment process. Following this two week
period, Medicaid providers and waiver program
providers will be entering the IMPACT
system to validate
and
update their information if currently enrolled or will be entering the system to initially enroll. The IMPACT provider
portal is designed to require that providers associate (link) to their appropriate billing agent in order for
their applications
to
be approved.
NOTE: Billing agents must
enroll into the IMPACT system AND enroll into the
Medical Electronic Data Interchange (MEDI) System.
Billing agents are encouraged to check the Illinois
IMPACT website regularly,
http://IMPACTinfo.illinois.gov in order
to stay informed of timelines and specific requirements.
Additional details will be posted as new information becomes available. Please check the IMPACT website periodically
for updates, and contact the IMPACT Help Desk at IMPACT.Help@Illinois.gov or by telephone at (877) 782-5565 option #1 with questions.
