Illinois Medicaid Program Advanced Cloud Technology (IMPACT) Provider Type Selections
| To: | Enrolled Medical Assistance Providers |
| Date: | May 13, 2016 |
| Re: | Illinois Medicaid Program Advanced Cloud Technology (IMPACT) Provider Type Selections |
The purpose of this notice is to remind providers to select ALL of the correct Specialty/Subspecialty combinations upon completion of the initial application or revalidation in the IMPACT system. Failure to select all of the correct Specialty/Subspecialty combinations could result in delay and/or rejection of claims.
It is important to make the correct selection of specialties/subspecialties in the IMPACT system in order to be reimbursed for all of the categories of services currently provided to Medicaid participants. The Department transfers this data from the IMPACT provider enrollment system into the system that processes provider claims known as the Legacy MMIS system. This data exchange of information updates Legacy MMIS files from the completed and approved IMPACT enrollment data. Therefore, if the data is omitted or incorrect on a provider’s IMPACT application, it will then be transferred into the Legacy system incorrectly. Claims submitted with information that is different from the most recent provider information sheet, may be delayed in processing or rejected. The provider information sheets are mailed upon enrollment approval in IMPACT and completion of data transfer into the MMIS system. Providers are responsible to review information for accuracy.
Record evaluation has identified situations where providers have NOT included all of their Specialties/Subspecialties under one IMPACT enrollment. Instead, some providers have incorrectly completed a separate enrollment for each Specialty/Subspecialty. When a separate application is completed for each Specialty/Subspecialty, additional Legacy Medicaid Provider ID numbers are generated for the provider. Consequently, claims reject because the system does not recognize the ID numbers that were subsequently created. For example, a Hospital should enroll choosing provider type “Hospital”. Then, in the same IMPACT enrollment application, select all applicable Specialty/Subspecialties, such as Inpatient, Laboratory/X-ray, Dialysis, etc. It is critical for payment of claims that only one IMPACT application is submitted that includes all services that will be billed under the single Legacy Medicaid Provider ID.
Providers are encouraged to review the table of IMPACT Provider Types, Specialties and Subspecialties. This reference guide on the IMPACT website, provides important information for providers who may have questions regarding these issues. If providers have an approved application in IMPACT, it may be necessary to review and correct information based on the instructions discussed in this notice. All changes to provider information must be electronically submitted by the provider through the IMPACT provider enrollment as a modification and are not effective until approved by HFS staff and transferred to the Legacy MMIS system.
Providers are encouraged to review IMPACT presentations and materials regarding provider enrollment and revalidation on the HFS website. The downloadable files are available to guide you through the process to complete a new enrollment or revalidation in the IMPACT system. The enrollment type definition is listed with each link to help you choose the proper steps to follow.
For additional information on the IMPACT system including frequently asked questions and other training guides visit the IMPACT website. Click on the “Provider Types” tab for additional information regarding provider types, specialties and subspecialties.
If you have additional questions or need assistance, please contact the IMPACT Help Desk:
- By email: IMPACT.Help@Illinois.gov
- By phone: (877) 782-5565 Select option #1.
Felicia F. Norwood
Director
