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Sick and Tired of Claim Denials with Medicaid Managed Care? Check Out a New Online 'Billing Manual'
Posted on: 3/11/2019

IAMHP represents the six Medicaid managed care insurers operating in Illinois:

  1. Blue Cross and Blue Shield of Illinois
  2. NextLevel
  3. IlliniCare Health
  4. Meridian Health Plan
  5. Molina Healthcare
  6. CountyCare Health Plan

If you have been grappling with repeated claim denials in the Medicaid managed care program, here's good news! 

A new comprehensive manual for billing is now available online. The goal of this free resource is to help reduce claim denials and deliver consistent services for patients.

The real gem behind this resource is that it provides a "one-stop shopping document" for billing and claims procedures – you no longer need to look up each health plan or provider-specific process separately!

The Illinois Association of Medicaid Health Plans (IAMHP) developed the manual in conjunction with the state's Department of Healthcare & Family Services.

Access the IAMHP Comprehensive Billing Manual.

Updates and revisions will be provided to the online manual at least quarterly.

While the billing manual will be helpful in addressing issues with Medicaid managed care, it won't fix everything. Other issues that contribute to high denial rates must also be addressed.

Please note: The billing manual only pertains to HealthChoice Illinois (HCI) Managed Care Organizations (MCOs) and services provided to Medicaid beneficiaries in Medicaid-only programs.

Questions? Contact ISMS' advocacy team at 800-782-4767 ext. 1470, or by email

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