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MedicaidAdministrativeMedium impact

Dental Member Eligibility Verification

Illinois Medicaid - HFS·IL · Dentistry·Provider Notice
Effective date
Jun 3, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Illinois Medicaid is instructing dental providers to verify member eligibility using the Department's official systems (AVRS at 800-842-1461 or MEDI online system) rather than relying on DentaQuest's web portal. This ensures accurate eligibility verification before providing services and prevents claim denials due to eligibility issues.

Action Required

Action needed
Immediately: Dental billing staff must stop using DentaQuest's web portal for eligibility verification. Use the Automated Voice Response System (AVRS) at 800-842-1461 or the Medical Electronic Data Interchange (MEDI) online system to verify member eligibility before all dental services. Report any eligibility discrepancies found with the DentaQuest portal to a DentaQuest provider representative immediately.