MedicaidAdministrativeMedium impact
Utilization Review – Revisions to Concurrent Review Procedures
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 1, 2006
We identified it
Jun 21, 2026
Summary
Hospitals can now request concurrent reviews for short stays (3 days or less) within 7 days after discharge, and for longer stays within 30 days after discharge, both using HSI's web-based system. These changes provide additional opportunities to obtain coverage approvals for inpatient stays that may not have been initially reviewed.
Action Required
Immediately: Billing and utilization review staff must familiarize themselves with HSI's web-based review request system. For short stays (3 days or less), submit concurrent review requests within 7 days of discharge. For longer certified stays, submit requests within 30 days of discharge. Ensure all claims are submitted within 12 months of the 'Through' date of service to maintain eligibility for payment.