Medical billing services in Illinois
Illinois practices often deal with a concentrated commercial market alongside a Medicaid program that runs largely through managed care. In the Chicago area, a practice may also serve patients from Indiana or Wisconsin, adding out-of-state plans to the mix.
We work with Illinois providers remotely, from busy Chicago and suburban groups to practices in Peoria, Springfield and the rest of downstate. We work inside your existing systems, keep close watch on Medicaid managed care requirements and give you one dedicated account manager to keep things clear.
IL
Practices we support in
- Chicago
- Naperville–Aurora
- Rockford
- Peoria
- Springfield
And everywhere else in Illinois. We work fully remotely.
The Illinois billing landscape
What makes billing here different, and what we keep an eye on for you.
Medicare through National Government Services
National Government Services is the Medicare Administrative Contractor for Illinois, part of Jurisdiction 6. We follow NGS billing guidance and local coverage determinations for traditional Medicare claims.
Illinois Medicaid and HealthChoice Illinois
Illinois Medicaid is administered by the Department of Healthcare and Family Services, and most members are enrolled in HealthChoice Illinois managed care plans. Providers generally need to be enrolled with the state as well as with each plan they bill, so we track both. Requirements change, so we verify current details with HFS and the plans.
A concentrated commercial market
Blue Cross and Blue Shield of Illinois holds a large share of commercial coverage, with national carriers also active. Its many products and networks can have different rules, so we confirm the specific plan at each visit.
Workers’ compensation and prompt-pay rules
Illinois workers’ compensation claims follow a state fee schedule and processes overseen by the Illinois Workers’ Compensation Commission. State prompt-pay rules also set deadlines for clean claims on state-regulated plans and for state Medicaid payments. We confirm current rules before relying on them.
Payer programs, contractors and plan lists change. We verify current requirements before we bill.
Our services in Illinois
Billing in Illinois: common questions
A free revenue audit for your Illinois practice
See where claims are stalling with your payers, and what we’d change first.