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Illinois Medicaid - HFSMedicaid · Administrative · Claims & Billing · ILHigh impact

Update to Hospital Reimbursement Component Hold Edits

Act
by Oct 14, 2026
Effective date
Mar 23, 2026
Identified
Jun 16, 2026

Summary

Hospital claims held since October 2025 and January 2026 have been released as of March 23, 2026. Claims past the 180-day timely filing limit can be rebilled using override forms or by calling for systematic override, but must be submitted within 180 days of this notice (by October 14, 2026).

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What to do

by Oct 14, 2026 · 2 steps
01Hospital billing teams must rebill any Fee-For-Service claims that were on hold and are past the 180-day timely filing limit using HFS 1624A UB-04 Override Request Form with G55 override, or call 877-782-5565 Options 1, 2, 4, 1 on Monday/Wednesday/Friday 8:30a-2:30p for systematic override.
02Review and resubmit any previously held H98, I42, and I43 hold edit claims.
If missed: Failure to act within 180 days will result in permanent claim denial.

Original notice

Update to Hospital Reimbursement Component Hold Edits
hfs.illinois.gov · Always check the source before changing claims.
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Illinois Medicaid - HFS policiesIL policy changes

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