MedicaidPrior AuthMedium impact
Illinois Health Connect Referral System Implementation – Phase I
Illinois Medicaid - HFS·IL · Family Medicine, General Practice, Internal Medicine·Provider Notice
Effective date
Oct 1, 2009
We identified it
Jun 21, 2026
Summary
Illinois Health Connect is implementing a referral system in phases by region starting October 1, 2009. PCPs treating Illinois Health Connect patients not on their panel must obtain referrals from the patient's assigned PCP to receive reimbursement, though specialists are exempt in Phase I.
Action Required
By October 1, 2009 (Northwest Counties) through April 1, 2010 (other regions): Billing team must verify Illinois Health Connect patient panel enrollment before services. For out-of-panel patients, providers must obtain referrals through the Illinois Health Connect Provider Portal via MEDI system or by fax/phone before providing services. Update workflow to check referral status as claims will be processed but not reimbursed without proper referrals.