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Attention Medicaid Providers: Verifying Member Eligibility

Posted December 29, 2017

As you know, Blue Cross and Blue Shield of Illinois (BCBSIL) is participating in the Illinois Department of Healthcare and Family Services (HFS) expanded Medicaid managed care program. BCBSIL is working diligently to process the member eligibility file received from HFS. While we expect member eligibility information to be accessible to providers by Jan. 1, 2018, due to the timing of receipt of the HFS file, it is possible that some providers may experience a delay when checking eligibility and benefits for members enrolled in Blue Cross Community Health PlansSM (BCCHPSM).

Providers are advised to check eligibility and benefits for Medicaid members online using the AvailityTM  online portal or the MEDI application  on the secure myHFS website. If you do not have access to the MEDI application to check Medicaid member eligibility and benefits, and/or if you have questions or need additional assistance related to the above issue, contact BCBSIL customer service at 877-860-2837.

If your patients have questions or concerns, please alert them to contact the customer service number on their BCBSIL member ID cards for assistance. If the member does not yet have their member ID card, they should contact BCBSIL customer service at the number listed above for more information.

Checking eligibility and/or benefit information 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, please call the number on the member’s ID card.

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 offered by third party vendors such as Availity. If you have any questions about the products or services offered by such vendors, you should contact the vendor(s) directly.