MedicaidAdministrativeMedium impact
Practitioner Newborn Claim Submission to HealthChoice Illinois Managed Care Plans
Illinois Medicaid - HFS·IL · Pediatrics, OB-GYN, Family Medicine·Provider Notice
Effective date
Nov 7, 2019
We identified it
Jun 20, 2026
Summary
HealthChoice Illinois managed care plans now allow practitioners to submit newborn claims under the mother's RIN when the baby hasn't been assigned their own recipient identification number yet. Claims will be denied initially but can be resubmitted once the newborn gets their RIN, with the original rejection date counting for timely filing purposes.
Action Required
Immediately: Billing team must update workflow for newborn claims in HealthChoice Illinois managed care plans. When newborn lacks RIN, submit claims under mother's RIN first. Track denied claims and resubmit with correct newborn RIN once assigned. Check MEDI system after day 46 for newborns added 46-364 days after birth to determine if claims go to MCO or HFS fee-for-service.