In this uncertain time, the health and well-being of CountyCare members is our top priority. We have created this page to provide you with the most up-to-date information about COVID-19 and the best way to get needed services during this public health emergency. Please save this page and check back often.
For more details on how to protect yourself and your family visit the Centers for Disease Control’s (CDC) Coronavirus prevention website. If you have additional questions, you can also call the Illinois Department of Public Health (IDPH) at 800-889-3931. Note that this phoneline is experiencing longer than normal hold times due to the COVID-19 crisis.
CountyCare will cover all diagnostic testing for medically necessary lab tests to diagnose COVID-19. Your CountyCare doctor doesn’t have to ask us for the OK to test for COVID-19.
The first thing you should do is call your doctor. Your doctor will determine whether it is appropriate for you to be tested based on guidance from the Centers for Disease Control, including your symptoms and your risk for complications. Do not go to your doctor’s office or the emergency room without calling first.
It is important that you stay home except to get medical care and stay away from others in your home. More details are available on preventing the spread of the virus on the CDC’s website. If you have additional questions, you can also call the Illinois Department of Public Health (IDPH) at 800-889-3931. Note that this phoneline may be experiencing longer than normal hold times due to the COVID-19 crisis.
To limit trips to the pharmacy, you may be eligible for an early drug refill or to receive medicines by mail. The CountyCare Pharmacy Help Desk is available 24 Hours a day, 7 days a week at 1-888-402-1982 to help you access your medications.
If you would like to get your medicine by mail from MedImpact’s Mail Order Pharmacy please follow the steps outlined here.
Social distancing is increasing the physical space between people to avoid spreading illness. Staying at least six feet away from other people lessens your chances of catching COVID-19. We encourage all members to practice social distancing to stop the spread of coronavirus disease (COVID‐19). Social distancing also includes limiting large groups of people coming together, closing buildings or canceling events
Based on available evidence, children do not appear to be at higher risk for COVID-19 than adults. While some children and infants have been sick with COVID-19, adults make up most of the known cases to date. Although children may not show symptoms of COVID-19 they can be carriers (spread) the virus. Like adults, children with pre-existing health conditions remain at high risk. You can visit the CDC website to learn more about preventing COVID-19 in children.
The COVID-19 situation is changing quickly. For the most up to date information you can visit the Centers for Disease Control and Prevention (CDC) Coronavirus website. If you have additional questions, you can also call the Illinois Department of Public Health (IDPH) at 800-889-3931. Note that this phoneline may be experiencing longer than normal hold times due to the COVID-19 crisis
Yes, all Illinois residents need to comply with the Governor’s executive order. The executive order states all Illinois residents are ordered to stay at home or in their place of residence until further notice. All persons may leave their home only for essential activities. Some essential activities may include things for your health and safety (food or health supplies), outdoor activities (if social distancing is maintained) or to take care of others. The Governor’s order also calls for all businesses that are not considered “essential” be closed. Only essential businesses will remain open. Examples of “essential” businesses include stores that sell food or medicine, gas stations and businesses that provide transportation services, financial institutions, government services, and hardware stores. For a complete listing of essential services and more details on the “Stay at Home” executive order visit the State of Illinois Coronavirus COVID-19 Response website.
Telehealth is a way of seeing your doctor without going to their office. Your visit could be over the telephone or by using an app like Facetime or Zoom. You should call your provider’s office to see if telehealth is available and ask them any questions you might have. CountyCare wants to keep you as safe and healthy as possible during the COVID-19 emergency and help prevent the further spread of Coronavirus.
All of us at CountyCare want to extend our deep appreciation for the work our providers are doing under very challenging circumstances. Please note that we are communicating with our members on a frequent basis with regard to preventing the spread of COVID-19. We are having members reach out first by phone to their providers for direction if they experience symptoms. Per your contract, you are required to have 24 hour coverage, 7 days per week. We thank you for being the first line of defense for our members.
CountyCare is actively monitoring the rapidly evolving coronavirus outbreak, including guidance from trusted sources of clinical information such as the Centers for Disease Control (CDC) and World Health Organization (WHO). We are focused on ensuring the well-being of our members during this crisis, with a particular focus on the most vulnerable. In addition, we are adjusting our business processes to facilitate and simplify access to care.
Below you can find the most up-to-date information regarding how CountyCare is responding to the COVID-19 public health emergency. We have included COVID-19 related testing, coding and other general information for our health care providers. Please save this page and check back often for updates.
2021 Annual PA Changes – December 2020 [PDF]
Final Reminder – Authorization Reinstatement as of 9/1/20 – August 25, 2020 [PDF]
COVID-19 Prior Auth Temporary Changes – Updates June 2020 [PDF]
COVID-19 Prior Auth Temporary Changes [PDF]
COVID-19 Transportation Prior Auth Temporary Changes [PDF]
COVID-19 Hospital Administrative Day Policy – May 2020 [PDF]
Administrative Days Authorization Request Form – May 2020 [PDF]
CountyCare will cover all diagnostic testing for in network providers for medically necessary lab tests to diagnose COVID-19. Your CountyCare doctor doesn’t have to ask us for the OK to test for COVID-19.
Patients who have concerns that they may have been exposed to COVID-19 or may have symptoms of COVID-19 should contact their provider or local/state Department of Health for testing. The test specimens will be obtained and then sent to a laboratory.
There is a shortage of COVID-19 kits available nationally. We encourage you to verify that testing is available before having a patient travel to a test site. Note that all tests require a doctor’s order and that other requirements, such as severe symptoms, may be in effect until testing is more widely available.
CMS has adopted two Healthcare Common Procedure Coding System (HCPCS) codes(U0001) and (U0002), for COVID-19 testing. HFS is using these codes for Medicaid billing purposes.
If the health plan receives notification of a positive result, we will notify the provider’s office via phone.
Please notify CountyCare of any positive cases at CountyCareQualityofCare@cookcountyhhs.org. Remember to send this communication via secure email to safeguard the privacy of the individual. Continued adherence to Privacy and Security Rules (HIPAA) is very important.
Please include the following information in your message:
Yes, we will allow out-of-network care, however, a prior authorization is required.
Yes. The Illinois Department of Healthcare and Family Services (HFS) has issued new telehealth administrative rules due to the COVID-19 public health emergency. These new rules were developed to enhance access and protect public health during the COVID-19 crisis by giving providers more flexibility to provide services via technology such as video conference or telephone.
Amongst other changes, HFS modified rules on “originating site” to include a patient’s place of residence. No licensed health care professional will be required to be present with the patient at the originating site. Additionally, the types of distant site providers were expanded to include new provider types such as Community Mental Health Centers (CMHCs) and certified Substance Use Disorder providers. In addition, there are new provisions for provider “virtual check-ins” and “E-visits”. These expansions are intended to provide remote access to care will help to keep members healthy and prevent further community transmission of COVID-19.
For more information, please see the Telehealth guidance issued by the Illinois Association of Medicaid Health Plans (IAMHP) in conjunction with HFS. This includes a Provider Notice on Telehealth requirements and an updated Billing Guide.
Yes. To encourage social distancing, CountyCare is making the following changes to its pharmacy benefits.
The Pharmacy Help Desk is being staffed to manage increased call volume from our members and providers. The Pharmacy Help Desk is available 24 Hours a day, 7 days a week at 1-888-402-1982.
No. CountyCare’s claims processing, call center and payment processing functions are fully operational.
Yes. The 180-day timely filing limit will be extended to 60 days after the end date of the public health emergency.
Awaiting further guidance and approval by CMS.
No. CountyCare’s appeals processing function is fully operational.
Not at this time. CountyCare’s concurrent review function continues to be fully operational.
There are numerous relief options available for providers that are also small-business owners. For more information, visit the US Small Business Administration, the State of Illinois, Cook County and City of Chicago websites.
HFS issued a provider notice on applying for Medicaid coverage during the pandemic. As DHS offices are currently closed, the State of Illinois is encouraging applicants for medical coverage to apply online at www.ABE.Illinois.gov. Applicants are also encouraged to answer all application questions as completely as possible and to submit the application, even if that means the applicant can not submit verification documents at the time of application. To apply by phone, applicants can call the ABE call center at 1-800-843-6154 but may experience long wait times.
Providers who are working with uninsured patients who need testing or treatment for COVID-19 should help patients to promptly apply for medical coverage. For expedited processing, please assist the patient in submitting their application through www.ABE.Illinois.gov and immediately send an email with the application tracking number to HFS.Priority19@illinois.gov. Providers are encouraged to have patients submit an application even if it is unclear as to whether a COVID-19 involved patient may be eligible for medical coverage.
