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
06/10/2025 – Provider Lunch & Learn: Provider Orientation
05/09/2025- Update: Change Healthcare Cybersecurity Breach
5/09/2025- Provider Lunch & Learn: IAMHP Universal Roster + Access and Availability Standards
04/30/2025- UPDATE: ER Claims Coding Consistency Policy
04/29/2025- Prior Authorization (PA) Change effective 4/1/25
04/18/2025- Provider Lunch and Learn- Health Equity
04/16/2025- 2025 Annual Notice for CountyCare Providers
04/01/2025 – Preferred Drug List – Formulary Update
04/01/2025 – Emergency Room Claims Coding Consistency Policy
04/01/2025 – Prior Authorization Changes Effective 05/23/2025
03/20/2025 – Prior Authorization Change Effective 1/22/25
02/19/2025 – Updated Provider Manual
02/05/2025 – Prior Authorization Change Effective April 5, 2025
02/05/2025 – Procedure Codes Added to the Prior Authorization List Effective April 2025
01/23/2025 – Advanced Imaging and Cardiology Authorization Changes
01/23/2025 – Musculoskeletal Surgery and Interventional Pain Management Authorization Changes
01/23/2025 – Physical, Occupational and Speech Therapy Services Authorization Changes
01/23/2025 – Behavioral Health (BH) Administrative Day Authorization Support Effective 02/24/25
12/30/2024- CountyCare Rewards and Benefit Updates
12/27/2024 – Prior Auth Change – Medications on the Medical Benefit – Effective 3/1/2025
12/27/2024 – Prior Auth Change – Evolent Specialty Services – Effective 3/1/2025
11/15/2024 – Early Delivery Protocol Updated – Effective 11/1/2024
11/12/2024- Optum Pre-Payment Review Program
11/04/2024- Procedure Codes Removed from Prior Authorization List- Effective January 1, 2025
11/04/2024- SUPR Expanded Services Program Effective 12/1/2024
10/29/2024- Climate Change
10/29/2024- Evicore
10/29/2024- 2024 Vaccine Updates
10/8/2024- Provider Town Hall
10/01/2024- Attention CountyCare Providers – Medicaid Provider Revalidation
09/25/24- Prior Authorization Changes Effective 11/26/2024
09/19/2024- Postpartum Bonus Payments
09/12/2024- Provider Lunch & Learn – Utilization Management
09/11/2024- Updated CountyCare Network Management Team
09/11/2024- Updated CountyCare Provider Manual
8/20/2024- Provider Lunch & Learn- IAMHP Universal Roster Training
07/19/2024- CrowdStrike Global Outage
07/10/2024- Procedure Codes Removed from Prior Authorization Look-Up Tool
07/10/2024- APR-DRG Billing Clarification
07/02/2024- Non-Emergency Medical Transportation Transition
06/06/2024- Prior Authorization Changes Effective 08/09/2024
05/01/2024- CountyCare UM Webinar: Elective Deliveries Policy
04/29/2024- Naloxone Utilization
04/29/2024- New CountyCare Partnerships
04/29/2024- Living Well Program
04/23/2024 – SUPR Services Notification Requirements
04/16/2024- Prior Authorization Changes- Effective 6/17/24
04/08/2024- Measles and Flu Vaccinations: Identifying Care Gaps
04/04/2024 – Endodontic Benefit Expansion
02/28/2024- Change Healthcare Cybersecurity Breach
02/21/2024- Prior Authorization DME Changes- Update
02/21/2024- Enhanced Respiratory Care (ERC) Program Update- Referral Process
02/21/2024- Prior Authorization Changes Effective 2/22/2024
02/15/2024- Prior Authorization Changes
02/14/2024- Newborn Eligibility and Authorizations Update
01/11/2024- Update to Prior Authorization (PA) Look-Up Tool
01/11/2024- CountyCare Eventa Training
01/10/2024- New EDI Edits and Billing Clarification for Inpatient Claims
01/10/2024- New EDI Edits and Billing Clarification for FQHC Claims
12/26/2023- New Member Population January 2024
12/22/2023- 2024 Annual Provider Notice
12/20/2023- Updated Notice December 2023 -Change in payment for early elective deliveries effective October 3, 2022
12/13/2023- Progeny Authorizations and Newborn Eligibility Update
11/15/2023- IAMHP Universal Roster Training
11/08/2023- Prior Authorization Changes for 2024 effective 01/10/2024
10/17/2023- Change in criteria used for Bariatric Surgery Approval
10/12/2023- Vaccines: COVID-19, RSV & Influenza
10/12/2023- eviCore Training Schedule for Prior Authorization Change effective 11/1/23
10/12/2023- Utilization Management of Neonatal Intensive Care Newborns
10/3/2023- CountyCare Health Plan Illinois Crown Benefit Revisions Effective 11/15/2023
9/01/2023- eviCore to Manage Durable Medical Equipment Authorization Requests
9/01/2023- CountyCare Health Plan Illinois Adult Partial Benefit Revisions Effective 10/01/2023
8/24/2023- Electronic Prior Authorization (ePA)
8/14/2023- New Program to Improve Outcomes for the Complex Respiratory Patient: Effective 10/16/23
8/04/2023 – Provider Satisfaction Survey
7/27/2023 – Reference Claim Required on Corrected Claim Submission
7/21/2023- Hospital Administrative Policy
7/12/2023- Prior Authorization Changes Effective 9/12/2023
7/12/2023- Change in Authorization for Newborn Admissions Effective September 13, 2023
6/30/2023- Illinois Preferred Drug List – Formulary Update
6/23/2023- Hepatitis C Drug Prior Authorization Removal
6/15/2023 – Vision Benefit Update
6/15/2023 – Adult Orthodontic Benefit Revisions
6/13/2023- Provider Notice Pharmacy Benefit Manager (PBM) Change
6/6/2023 – Elective Deliveries Phase 2
5/26/2023 – Multiple Place of Service (POS) Intake Update
5/16/2023 – Updated: CountyCare Network Management Team
5/15/2023 – Prior Authorization Requests for Lung and Lobar Transplants
5/15/2023 – Prior Authorization Changes 2023
5/15/2023 – Fertility Preservation Changes
5/11/2023 – 2023 ICD-10 Coding Update
4/17/2023 – Universal IAMHP Roster Trainings
3/01/2023 – 2023 Annual Provider Notice
2/17/2023 – Utilization Review Policy Update: Authorization for Observation vs. Inpatient Level of Care
1/19/2023 – UM Extension Requests for Prior Authorizations
12/31/2022 – 2022 Annual Provider Notice
12/23/2022 – REVISED: 2023 Formulary Updates
12/15/2022 – Current Billing Requirements for Hyperbaric Oxygen (HBO) Treatment
12/14/2022 – Prior Authorization Changes for 2023
11/30/2022 – Provider Relations Department Update
11/25/2022 – 2023 Formulary Updates
11/16/2022 – EDI Gateway Update: Availity
10/31/2022- SMART Act Authorization Changes Effective October 31, 2022
9/20/2022 – 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
2/15/2022 – CountyCare Peer-to-Peer Review – Update
1/28/2022 – Taxonomy Codes Required on Claims Submission or Claim Could be Rejected
1/14/2022 – COVID-19 Prior Authorization Temporary Changes for Skilled Nursing Facilities
1/21/2022 – Enhancements to Utilization Management Provider Portal (See Quick Reference Guide)
12/31/2021 – 2021 Annual Provider Notice
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]