April 2019
Attention Illinois Medicaid Providers: Submit Benefit Preauthorization Requests Online for Intensive Outpatient Program (IOP) Services
As a reminder, providers offering behavioral health IOP services may use iExchange® to submit IOP benefit preauthorization requests online for our Illinois Medicaid members. For instructions on how to submit IOP benefit preauthorization requests through iExchange for Illinois Medicaid, refer to our new tip sheet. This tip sheet and other helpful resources may be found in the Provider Tools section of our website, under iExchange.
iExchange is available 24 hours a day, 7 days a week.* It may be accessed by physicians, professional providers and facilities who have obtained a provider record with Blue Cross and Blue Shield of Illinois (BCBSIL). Refer to the iExchange page for more information, including our online enrollment form. Or, if you’re a registered Availity® Provider Portal user, you may enroll to use iExchange via BCBSIL’s Payer Spaces – select the Resource tab, then “Pre Auth Registration.” There is no cost to use iExchange or Availity.
Customized training is available for providers who are new to iExchange. To request training, email our Provider Education Consultants. For ongoing support, email our iExchange Help Desk, or call 800-746-4614.
Don’t Forget: Check Eligibility and Benefits First
It’s critical to check eligibility and benefits for each patient to confirm coverage details. This step will also identify benefit preauthorization requirements and specify utilization management vendors that must be used, if applicable. Submit online eligibility and benefits requests (electronic 270 transactions) via the Availity Portal or your preferred web vendor portal. Obtaining benefit preauthorization is not a substitute for checking eligibility and benefits.
Learn More About iExchange and Availity
BCBSIL offers ongoing general webinars that emphasize using electronic options.
- Join us for an iExchange webinar to learn how to access and navigate our online benefit preauthorization tool.
- Also sign up for a BCBSIL Back to Basics: ‘Availity 101’ webinar for an overview of electronic transactions, such as eligibility and benefits, which may be conducted via the Availity Portal.
See the Provider Learning Opportunities for dates and times of upcoming webinars. To register to attend, visit the Webinars page. Questions? Contact your Provider Network Consultant (PNC).
This information does not apply to services for HMO members.
Please note that checking eligibility or benefits, or the fact that a service has been preauthorized, is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have any questions, call the number on the member’s ID card.
iExchange is a trademark of Medecision, Inc., a separate company that provides collaborative health care management solutions for payers and providers. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Medecision and Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.