July 8, 2022
If you’re attested with the Illinois Department of Healthcare and Family Services (HFS) to provide care and services to Illinois Medicaid members, you must confirm your certification or licensure on file in the Illinois Medicaid Program Advanced Cloud Technology (IMPACT) system is current. This is a condition of participation in the Medicaid program.
For professions that require a certification or licensure in the state of Illinois, these credentials must remain active. This requirement includes the Clinical Lab Improvement Amendments Certification, administered by the Illinois Department of Public Health Office of Health Care Regulation. Failure to maintain current certifications or licensing on file with IMPACT may result in claim rejections or denials.
If a claim submitted to Blue Cross and Blue Shield of Illinois (BCBSIL) is rejected with an eligibility verification message related to the National Provider Identifier (NPI) or Atypical Provider Identifier (API), proceed as follows:
Verify the NPI(s) or API submitted on the claim are correct and match your provider enrollment information in IMPACT.
If all NPI/API information is correct, contact IMPACT to check your certification or license on file and bring them up to date within the IMPACT system.
Call the number on the member’s BCBSIL ID card if you have claim-related questions or need more information related to services provided to BCBSIL members. If you have other questions, email your assigned Provider Network Consultant.