Provider Notices

Providers in the CountyCare network can access notifications, Town Hall presentations and other notices specific to providers here. Click on any of the PDFs below to view and download.

Notices

11/30/22 – Provider Relations Department Update 

11/25/2022: 2023 Formulary Updates

11/16/22: EDI Gateway Update: Availity 

9/20/22 – PCP Roster Updates for OB/GYNs and Pediatrics

9/6/2022 – Updated Notice: Change in Payment for Elective Deliveries, Effective October 3, 2022

8/3/2022 – Change in Payment for Elective Deliveries, Effective Oct. 3, 2022

7/22/2022 — UPDATED: Observation vs. Inpatient Level of Care

7/16/2022 – FQHC Covid-19 Fee Schedule EDI Updates

7/16/2022 – Same Calendar Day Admit and Discharge Inpatient Claims EDI Updates

7/7/2022 – COVID-19 Prior Authorization Temporary Changes for Skilled Nursing Facilities 

6/23/2022 – Amendment to Behavioral Health Appointment Time Frames

5/20/2022 – Observation vs. Inpatient Level of Care

5/18/2022 – Certificate of Transportation Services Form New Requirements

5/5/2022 – General Notice: POS 21/22 vs. 23 on ER Claims 

5/5/2022 – Telehealth Billing Guidance for SUPR Providers 

4/22/2022 – Urgent UM Request Process Change

4/15/2022 – Illinois Preferred Drug List: Formulary Update

4/13/2022 – HEDIS Measurement Reference Guide Available on the Website

4/5/2022 – Provider Dispute System and Process for 30-Day Readmissions Disputes 

3/15/2022 – 60-Day Notification of Prior Authorization Changes

3/11/2022 – UPDATE: Preferred Drug List Changes

3/10/2022 – Hospital Administrative Policy

2/15/2022 – CountyCare Peer-to-Peer Review – Update

1/28/22 – Taxonomy Codes Required on Claims Submission or Claim Could be Rejected

1/14/22 – COVID-19 Prior Authorization Temporary Changes for Skilled Nursing Facilities

1/21/22 – Enhancements to Utilization Management Provider Portal (See Quick Reference Guide)

12/28/2021 – Reminder PA Changes Effective 1/1/2022

12/17/2021 – Important Announcement: Non-Emergent Ambulance Transition Effective 1/1/2022

12/1/2021 – COVID-19 Prior Authorization Temporary Changes – Updates 

10/15/2021 – Car-T Therapy Policy and Procedure

8/13/2021 – Updated CountyCare Provider Manual

8/6/2021 – Criteria and Process in Selected Surgical Procedures

6/4/2021 – Inpatient Readmissions: Reimbursement Policy, Effective 7/1/2021

5/13/2021 – CountyCare Drug List – Update

5/11/2021 – COVID-19 Vaccine Waste Guidance for Providers 

4/30/2021 – Business Enterprise Program Certification Training for Providers 

4/28/2021 – COVID-19 Prior Authorization Temporary Changes – Updates

4/23/2021 – ACTION REQUIRED: Provider Roster Required Fields

4/17/2021 – Resumption of Timely Filing Effective June 1, 2021

4/6/2021 – COVID-19 Prior Authorization Temporary Changes – Updates

3/30/2021 – Formulary Updates Effective April 1, 2021

3/29/2021 – Provider Relations Representative Reference – March 2021

3/4/2021 – COVID-19 Prior Authorization Temporary Changes – Updates

3/1/2021 – COVID-19 Vaccine and Administration Billing

3/1/2021 – Non-Emergent Medical Transportation Ambulance Claims Update – March 2021

2/12/2021 – SUPPORT Act –New Updates Related to Opioids

1/14/2021 – COVID-19 Mass Vaccination Guidance for Providers

1/28/2021 – COVID-19 Prior Authorization Temporary Changes – Updates – February 2021 

1/1/2021 – Provider Relations Team Notice January 2021 [PDF]

COVID-19 Prior Auth Temporary Changes- UPDATES December 22, 2020 [PDF]

2021 Annual PA Changes – (December 2020) [PDF]

Important Utilization Management Updates – Effective January 1st, 2021 – (December 2020) [PDF]
Human Donor Milk Coverage Provider Notice – December 17, 2020 [PDF]
New Population Health Tool in the CountyCare Provider Portal – December 12, 2020 [PDF]

Illinois Preferred Drug List – December 1, 2020 [PDF]
Applied Behavior Analysis (ABA) Services Now Covered – November 25 2020 [PDF]
COVID-19 Prior Auth Temporary Changes- UPDATES November 25 2020 [PDF]
Provider Education Webinar: Provider Orientation and Provider Portal Review – November 2020 [PDF]
Policy and Procedure Manual Human Donor Milk – November 2020 [PDF]
Updates Regarding Claims Submission – November 2020 [PDF]
Open Enrollment in Illinois is Approaching – October 2020 [PDF]
Authorization Timelines and Decisions – October 2020 [PDF]
2020 Annual Notice for CountyCare Providers [PDF]
Prior Authorization Submission Checklist – October 2020 [PDF]
Provider Education Webinar: Home and Community-Based Services (HCBS) Waiver Providers – October 2020 [PDF]
New policy and procedure billing changes for Home and Community-Based Services (HCBS) waiver providers – September 2020 [PDF]
DCFS YouthCare Program Update – September 1, 2020 [PDF]
New False Claims Act and Whistleblower Protection Policy – August 2020 [PDF]
Final Reminder – Authorization Reinstatement as of 9/1/20 – August 25, 2020 [PDF]
COVID-19 Prior Auth Temporary Changes – August 11, 2020 [PDF]
Change to Ordering, Referring, and Prescribing (ORP) Policy, Effective 8/1/2020 – July 2020 [PDF]
Brighter Beginnings – Blood Pressure (BP) – July 2020 [PDF]
ACTION REQUIRED: Your IAMHP Roster is Needed or Your Claims may be Denied – July 2020 [PDF]
COVID-19 Prior Auth Provider Notice – July 2020 [PDF]
New Provider Phone Number for First Transit – May 2020 [PDF]
CountyCare Stands Ready to Support our Members, Provider Partners, and the Community During this Time of Unrest – June 5 2020 [PDF]
COVID-19 Prior Auth Temporary Changes – Updates June 2020 [PDF]
Important Utilization Management Updates – June 2020 [PDF]
COVID-19 Hospital Administrative Day Policy – May 2020 [PDF]
Prior Auth for Oncology – 2020 [PDF]
Urine Drug Testing UM Update – 2020 [PDF]
Universal Provider Roster – April 2020 [PDF]
COVID-19 Prior Auth Temporary Changes – April 2020 [PDF]
Billing Update related to Mobile Crisis Response – March 2020 [PDF]
Network Criteria for Selected Surgical Procedures – February 2020 [PDF]
Special Needs Children (SNC) Program Updates – February 2020 [PDF]
IMPORTANT UTILIZATION MANAGEMENT UPDATES – January 2020 [PDF]
IMPACT Provider Letter – December 23, 2019 [PDF]
Important Update: Ordering, Referring, Prescribing (ORP) – January, 2020 [PDF]
Nursing Facility Provider Notice – January 2, 2020 [PDF]
Important Update: Ordering, Referring, Prescribing (ORP) National Provider Identifier (NPI) Requirements – December 2019 [PDF]
Vision Providers Continuity of Care Extension – December 2019 [PDF]
Mobile Crisis Response Providers [PDF]
PROVIDER POLICY UPDATE NOTICE: Updates to Prior Authorization Requirements – Hospice Services [PDF]
2019 Annual Provider Notice [PDF]
Pharmacy Updates: Prescribing Provider [PDF]
Pharmacy Updates [PDF]
Corrected Claims, Claim Review, Provider Disputes, and Medical Necessity Appeals [PDF]
Provider Notice Stroger Hospital [PDF]
Provider Notice Dental & Vision Coverage Change 2019 [PDF]
Important Update related to HCBS Waiver Billing, September 2019
Utilization Management Services – Cardiology/Oncology Frequently Asked Questions (FAQs)
New Utilization Management/Quality Program for Oncology Services [PDF]
New Utilization Management/Quality Program For Cardiology Services [PDF]
MLTSS Claim Processing Hold [PDF]
Authorization Portal Enhancement Effective 7/1/2019 [PDF]
Provider Relations Team Notice May 2019 [PDF]
2018 Annual Notice for CountyCare Providers [PDF]
Pharmacy Notice: MedImpact Direct Specialty Update [PDF]
Provider Account Inactivity [PDF]
Important Update to LTC and SLF Prior Authorizations – May 2019 [PDF]
Pharmacy Notice MedImpact Direct Specialty – April 12, 2019 [PDF]
CountyCare Primary Care Provider Policy Update – April 9, 2019 [PDF]
CountyCare Has New Dedicated Fax Line for All Reports of Critical Incidents April 1, 2019 [PDF]
Pharmacy Benefit Manager (PBM) Change March 2019 [PDF]
Transportation Card Distribution Changes March 2019 [PDF]
Bariatric Provider Notice March 2019 [PDF]
UPDATE: Hand Price Code Reimbursement Methodology February 2019 [PDF]
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