Date: February 8, 2021
To: Enrolled Physicians, Physician
Assistants, Advance Practice Nurses, Local Health Departments, Federally
Qualified Health Centers, Rural Health Centers, Encounter Rate Clinics, Hospitals,
and Independent Laboratories
Re: Lab Testing and Claims Submittal Related
to COVID-19 – Launch of HFS COVID Portal
notice provides updated information to that communicated in the July 17, 2020 and September 25, 2020 provider notices regarding the
Department’s deployment of an online portal for reimbursement of COVID-19 testing
services for uninsured individuals who have been tested for COVID-19. Claims
for participants enrolled in a HealthChoice Illinois health plan should be
billed to the appropriate managed care plan.
is pleased to announce the launch of the HFS COVID Portal,
which is now ready to accept claims beginning with dates of service March 18,
2020. The portal is designed to receive and process claims for uninsured
individuals, regardless of income, citizenship, or immigration status. Providers are reminded to first check MEDI
for active Medicaid coverage and MCO enrollment before requesting a RIN and submitting
claims through the HFS COVID portal. Tests for customers who already have Medicaid coverage
should be billed through regular channels. Testing and testing-related covered
procedure codes are identified in the COVID-19 Fee Schedule.
the uninsured population,
providers should continue to use the Health Resources and Services Administration (HRSA)
COVID-19 Uninsured Program to request reimbursement for the following
services, regardless of income, citizenship, or immigration status:
testing and testing-related services for dates of service between February 4
and March 17, 2020
services for dates of service after March 17, 2020, as treatment is not covered
under the HFS COVID-19 Testing Program
HFS COVID Portal, the Department will accept patient information contained
within an Excel file layout. This online portal has the functionality to:
a RIN only - Providers
who want to generate their own claims can request the Department generate a
Recipient Identification Number (RIN)
only for the uninsured COVID-19 testing patients. Files containing RINs for
patients uploaded through the portal will be available for download by the
provider after the RINs are assigned. Uninsured individuals who have RINs
created through the portal will not receive a Medical Card.
Create both a RIN and Claim - The full functionality of the
portal will generate RINs and claims.
Create a claim if a current RIN is found
- If a RIN exists and
the participant is eligible for traditional Medicaid without MCO enrollment, a
claim will be generated. If the
participant is eligible through a Medicaid managed care plan, the claim will reject,
and providers must bill the plan.
duplicate RINs may be created through the HFS COVID Portal if providers submit
patient information for individuals who already have a Medicaid RIN with HFS. Providers
should first check MEDI for active Medicaid coverage and MCO enrollment before
requesting a RIN and submitting claims through the HFS COVID portal. MEDI will
display “COVID TESTING COVERAGE” for the new RINs created through the portal
that have coverage limited to COVID testing and testing related services.
Providers should continue to submit claims for other services through the
regular full coverage Medicaid RIN.
Qualified Health Centers (FQHCs) may bill specimen collection procedure code 99000
– Handling of Specimen for Transfer from Office to Lab, as fee-for-service utilizing
the full functionality of the portal. However, if an FQHC needs to bill a T1015
encounter for a testing-related service, it can only use the portal to
obtain a RIN. The FQHC will have to submit the encounter claim through its
normal billing process outside the portal once a RIN is obtained.
portal functionality allows the Department to generate non-institutional claims
for hospitals, even if the date of service is on or after July 1, 2020, when
hospitals transitioned to all-institutional billing. Please note, these are the only non-institutional
claims the system will process using a hospital’s NPI. A hospital may not submit a non-institutional
claim outside the portal.
reminder, providers must be enrolled with the Department to be reimbursed, and
a public domain Illinois.GOV e-mail
address will be required to login to the portal. Providers must create an
account at the Illinois.GOV website. More detailed registration
instructions are available on the homepage of the HFS COVID Portal.
following documents are linked below:
sample Excel file layout
regarding this notice may be directed to the Bureau of Professional and
Ancillary Services at 877-782-5565.
of Medical Programs
· COVID Portal Provider Upload File Layouts (pdf)
· COVID Testing
Submission File Layout Sample (xlsx)