FAQS - Digital Identity Certificates
How do I obtain a State of Illinois Digital Identity Certificate?
Why do I need a Digital Identity Certificate from the State of Illinois? Why can't I use my own certificate?
How many digital identities do I need to have?
How do I protect my digital identity from access by other people?
If I am planning on registering as a provider and I am not the provider, do I need the provider's driver's license to register for the digital identity?
If I do not live in Illinois, how do I get a digital identity?
FAQS - IEC
Is Medicaid-IL able to accept the ANSI837 4010A1?
What are your requirements for declaring a submitter production ready?
What are your test requirements (e.g. minimum number of claims, service types, etc.)?
Through what types of edits will you be processing our test file? Will you just be testing for construction or will you also make edits available that impact adjudication?
Description of test environment?
Does the test system have a dial-up number, or does it require a username and password?
How do I perform a system-to-system submission, and what protocol should I use?
Do we need to inform anyone once we make a submission?
What is the turnaround time for results once a submission is made? What type of results are made available?
FAQS - Medical Electronic Data Interchange (MEDI) System
How do I register my providers, by medical group or individually?
How many providers can I represent?
Is registration a manual process if the business is out-of-state?
How does "Other Business" enrollment and delegation to our employees work?
When can we begin and who will be our enrollment contact for assistance at HFS?
I currently have business relationships or agreements with IL Medicaid providers, at numerous practices and institutions, and assist them in filing their transactions electronically. In order to perform this service to them through your MEDI System, will each provider and institution have to grant me this authority within your new MEDI/IEC Systems?
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How do I obtain a State of Illinois Digital Identity Certicate?
Review the Obtaining a Digital Identity Certificate topic for instructions.
Why do I need a Digital Identity Certificate from the State of Illinois? Why can't I use my own certificate?
The State of Illinois is the certificate authority for all State of Illinois Internet access. Applications available over the Internet that are provided by the Department of Public Aid will only accept certificates from the State of Illinois.
How many digital identities do I need to have?
You only need one digital identity from the State of Illinois. Your digital identity is yours, and you can use it for access to other state agency applications.
How do I protect my digital identity from access by other people?
The digital identity certificate you have is installed in the browser when you access any State of Illinois systems by entering your digital identity's user id and password. Once you Logout successfully or close the browser, the certificate is removed from your computer. Do not share your user id and password with others. If you feel you need to protect your digital identity, you can change the password. Review the Changing Your Digital Identity Password topic for instructions.
If I am planning on registering as a provider and I am not the provider, do I need the provider's driver's license to register for the digital identity?
No. You can register for your digital identity with your own driver's license or identification card and then register as a provider in MEDI. MEDI understands that most of the time, a provider administrator will be registering and managing the provider's account.
If I do not live in Illinois, how do I get a digital identity?
If you do not have an Illinois driver's license or identification card, you can still register for your digital identity online. There are applications available online or out-of-state digital identities that can be printed and mailed in. Review the Obtaining a Digital Identity Certificate for more help.
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Acceptable HIPAA Formats
Is Medicaid-IL able to accept the ANSI837 4010A1?
Yes, Illinois accepts only 4010A1 format, except for the 824, which is accepted in 4050 format. For a complete list of transactions accepted by Illinois, review the Current HIPAA Transaction Set. However, not all transactions may be implemented yet. Check the IEC System Home Page for more information on which transactions are currently available
Certification for Trading Partners
What are your requirements for declaring a submitter production ready?
Illinois Department of Healthcare & Family Services (HFS) has no certification requirements for submitting files for production processing and no test environment to test your transactions. When you are satisfied your files are HIPAA-compliant, you may submit for production. Be sure to put 'P' in the ISA15 to submit for production.
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HIPAA-Compliance Testing
What are your test requirements (e.g. minimum number of claims, service types, etc.)?
Illinois Department of Healthcare & Family Services has no certification requirements for submitting files for production processing.
Through what types of edits will you be processing our test file? Will you just be testing for construction or will you also make edits available that impact adjudication?
Illinois Department of Healthcare & Family Services has no test environment. When you submit a file, HFS will apply Level I - Level IV syntax checking, which will result in a corresponding 997 or 824 response. ST-SE segments can also be rejected if the submitter is not authorized by the provider; and an 824 will be generated. Adjudication edits will be applied through the normal adjudication process, resulting in an 835 response.
Description of test environment?
Currently, HFS has no test environment to test your transactions. When you are satisfied your files are HIPAA-compliant, you may submit for production. Be sure to put 'P' in the ISA15 to submit for production.
Does the test system have a dial-up number, or does it require a username or password?
You will use our Web site and your login information from your registration for the digital certificate (after registration process is completed) to access MEDI. From there, you can access the IEC System, if you have authorization. Currently, HFS has no test environment to test your transactions. When you are satisfied your files are HIPAA-compliant, you may submit for production. Be sure to put 'P' in the ISA15 to submit for production.
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Submitting HIPAA-Compliant Transactions
How do I perform a system-to-system submission, and what protocol should I use?
HFS does not provide system-to-system or server-to-server submission. However, it may be developed at a later date.
You will be able to submit batch files for HIPAA-compliant transactions directly to HFS over the Internet with the new IEC System. To submit files, access the Internet Electronic Claims (IEC) System and click on the File Upload link. We only accept .TXT and .DAT filetypes.
Do we need to inform anyone once we make a submission?
No. The submission will be acknowledged by either or both a 997 and 824. If you do not get any kind of acknowledgment, you should contact the Help Desk.
What is the turnaround time for results once a submission is made? What type of results are made available?
You should receive one or more 997 acknowledgments within a few minutes of submitting a batch file. These acknowledgments indicate whether there are any problems with the enveloping or syntax of the submission.
You may also receive an 824 if there are transactions within the file that did not pass our authorization checking process.
Adjudication of claim submissions will fall under normal MMIS processing goals. Batch submissions for other HIPAA formats have a 24-hour response time. (overnight).
Responses to batch submissions will be provided as batch files in HIPAA-compliant format. These files can be downloaded from the IEC System to the user's computer.
There are DDE functions available for the 270 Eligibility Inquiry and 276 Claim Status Inquiry that provide an immediate response for single inquiries.
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Registration
How do I register my providers, by medical group or individually?
Providers must be registered individually. If you represent a medical group, clearinghouse or billing service with access to the Provider Information Sheet, the Group Registration for Provider Groups topic provides suggesstions on how to register.
How many providers can I represent?
You can represent as many providers as necessary. If you want to register as the provider administrator for each provider, you must have the appropriate Provider Information Sheet for each provider you want to register. You could also register as an employee of multiple providers. In this case, you would need the Employee Registration Key from the provider administrator(s) for each registered provider. For instructions, we have provided a list of Registration Tutorials to assist you through the registration process.
Is registration a manual process if the business is out-of-state?
No, once you obtain your digital certificate, you can register online through the MEDI System. Registration is required before you will be able to access any applications. Review the Registration Overview for more information.
How does "Other Business" enrollment and delegation to our employees work?
Other businesses (e.g. provider groups, billing services, clearinghouses, software vendors, etc.) may register in the MEDI System to work on behalf of a Medicaid provider. Then, the person (e.g. administrator) that registered the business can request authorization from the provider. Once authorization is received, it can be delegated to the registered employees. Read the Authorization Overview for more detailed information on both business authorization and delegation to employees.
When can we begin and who will be our enrollment contact for assistance at HFS?
You can begin now by obtaining your digital certificate and registering in the MEDI System. There are Help numbers available to call if you need assistance.
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Authorziation
currently have business relationships or agreements with IL Medicaid providers, at numerous practices and institutions, and assist them in filing their transactions electronically. In order to perform this service to them through your MEDI System, will each provider and institution have to grant me this authority within your new IEC System?
Yes. Each provider, by unique provider identification number, will have to authorize the specific MEDI transactions that your business will be allowed to access on their behalf. This process is required to affirm business relationships and prevent unauthorized access to MEDI. Review the Authorization Overview for more information about how to receive authorization.
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