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MedicaidAdministrativeMedium impact

Automated Adjustment Process for the Long Term Care Direct Billing System

Illinois Medicaid - HFS·IL · Geriatrics·Provider Notice
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

Illinois is implementing an automated adjustment process for Long Term Care Direct Billing System claims with service periods from December 1, 2016 forward. The system will automatically process adjustments for patient income changes, facility per diem changes, and developmental training adjustments on the second weekend of each month.

Action Required

Action needed
Long Term Care facilities should monitor monthly Remittance Advice statements for automated adjustments identified by reason codes 0001 (Change of Patient Income), 0205 (Facility Per Diem Change), and 3012 (Dev Training Adjustment Amount). Contact Bureau of Long Term Care at 844-528-8444 for questions about adjustments.

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