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Attention Illinois Medicaid Providers: Submit Benefit Preauthorization Requests Online for Intensive Outpatient Program Services

Posted December 14, 2018 [Updated December 21, 2018]

Effective Jan. 11, 2019, providers offering Intensive Outpatient Program (IOP) services will have the option to use iExchange® – our online benefit preauthorization tool – to submit benefit preauthorization requests for IOP services for Illinois Medicaid members. iExchange is available 24 hours a day, 7 days a week.*

iExchange is accessible to physicians, professional providers and facilities who have obtained a provider record with BCBSIL. To sign up and gain access, refer to the iExchange page for more information, including our online enrollment form. Or, if you are already a registered Availity® Provider Portal user, you may enroll to use iExchange via the BCBSIL Payer Spaces – select the Resource tab, then “Pre Auth Registration.” There is no cost to use iExchange or Availity.

Customized training is available for providers who have never used iExchange. To request training, send an email to our Provider Education Consultants at PECS@bcbsil.com. For ongoing support, you may contact the iExchange Help Desk at iEXCHANGE_HelpDesk@bcbsil.com or 800-746-4614.

 

Important Reminder: Always Check Eligibility and Benefits First 

It’s critical to check eligibility and benefits for each patient to confirm coverage details. This step will also identify benefit preauthorization requirements and specify utilization management vendors that must be used, if applicable. Submit online eligibility and benefits requests (electronic 270 transactions) via the Availity Portal or your preferred web vendor portal. Obtaining benefit preauthorization is not a substitute for checking eligibility and benefits.

Learn More About iExchange and Availity

BCBSIL offers a variety of webinars with an emphasis on using electronic options.

  • Join us for an iExchange webinar to learn how to access and navigate our online benefit preauthorization tool. Dates, times and online registration links for upcoming BCBSIL webinars, visit the Webinars page.
  • Also sign up for a BCBSIL Back to Basics: ‘Availty 101’ webinar for an overview of electronic transactions, such as eligibility and benefits, that can be conducted via the Availity Portal.

If you have any questions, please contact your Provider Network Consultant.

*With the exception of the third Sunday of the month from 11 a.m. to 2 p.m.

Please note that checking eligibility or benefits, or the fact that a service has been preauthorized, is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have any questions, please call the number on the back of the member’s ID card.

iExchange is a trademark of Medecision, Inc., a separate company that provides collaborative health care management solutions for payers and providers. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Medecision and Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.