IlliniCare Health is committed to providing our participating providers with the best tools possible to support their administrative needs. Our electronic transactions capabilities will speed up the processing and payment of your claims.
IlliniCare Health and PaySpan are in partnership to provide an innovative web based solution for Electronic Funds Transfers (EFT’s) and Electronic Remittance Advices (ERA’s).
Secure Web Portal
Partial list of secure website functions include verify member eligibility, check/submit claims and submit/confirm authorizations.
Electronic Transactions (EDI) support for HIPAA transactions is provided for the health plan by Centene Corporation. Centene is currently receiving professional, institutional, and encounter transactions electronically, as well as generating an electronic remittance advice/explanation of payment (ERA/EOP). To conduct other HIPAA transactions not listed, please contact our EDI department at 1-800-225-2573, ext. 25525.
The following list contains contact information for the trading partners currently active with our health plan. All providers are encouraged to contact one of these trading partners to utilize our electronic transaction options.
Our contracted clearinghouses are:
|Trizetto Provider Solutions||68066|
|Smart Data Solutions||68069|
|First Health Care||68069|
If you have any questions, please contact: IlliniCare Health c/o Centene EDI Department 1-800-225-2573, ext. 25525 or 1-314-505-6525. Or by email at EDIBA@centene.com
Tips for 5010 EDI Claims EDI Claims
- Correct Use of the Date of Service/Onset Date Fields
- If the onset date is the same as the date of service, leave the onset date field blank. Entering the same date on both the onset field and service field will cause an error.
- If the onset date is prior to the date of service, enter the two dates in their applicable fields.
- National Provider Identifier (NPI) vs Social Security Number (SSN)
- Be sure to sue the NPI and not an employer identification or social security number as the primary identifier on your claim.
Please visit https://www.ama-assn.org/practice-management/electronic-transaction-toolkits-administrative-simplification or https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/Versions5010andD0/index.html for more information on data reporting changes in the Version 5010 transactions.