Date: January 27, 2022
To: Enrolled Transportation Providers
Re: Non-Emergency Ground Ambulance Services for HealthChoice Illinois (HCI) Managed Care Organization (MCO) Plan Customers - Informational Documents Available Regarding Changes Effective January 1, 2022
This notice provides additional information and links related to the change for billing of non-emergency ground ambulance services for persons covered under the Department's HCI MCO Plans. Provider notices dated September 17, 2021 and December 14, 2021 outline this billing transition.
For those enrolled in the Medicare-Medicaid Alignment Initiative (MMAI) MCO Plans, this billing change is only applicable for non-emergency ground ambulance services not covered by Medicare. Otherwise, MMAI MCO Plan customers will continue to request non-emergency ground ambulance transportation through their approved MCO transportation broker.
Providers can access the following additional support documents regarding the transition on the Non-Institutional Providers webpage:
- A Frequently Asked Questions document for providers, that will be updated as needed.
- A flow chart to assist MCO customers needing to request non-emergency ground ambulance services.
Effective January 1, 2022 and thereafter, all MCO Plan customers and providers must obtain prior approval for non-emergency ground ambulance services through First Transit, the prior approval vendor for the Department. First Transit may be reached Monday through Friday, 8:00am to 5:00pm:
- Customers at 877-725-0569
- Providers at 866-503-9040
Additional information regarding First Transit's Non-Emergency Transportation Prior Approval Program (NETSPAP) can be accessed at their NETSPAP website.
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for fee-for-service issues, or to the applicable HealthChoice Illinois managed care plan.
Kelly Cunningham, Administrator
Division of Medical Programs