Ambetter Providers FAQ | Ambetter of Illinois

 

FAQ

For now, can you update the response to this bullet to say: If you have questions regarding your assigned PR representative, please e-mail Ambetter from IlliniCare Health Provider Relations team at providerrelations_IL@centene.com.

  • Claim reconsiderations must be received within 180 days of the DOS or date of discharge, whichever is later.
  • Claim disputes must be received within 90 days of paid date, not to exceed 1 year from DOS.
  • When IlliniCare Health is the secondary payer, claims must be received within 90 calendar days of the final determination of the primary payer.
  • For more information please refer to our Provider Manual (PDF).
  • If you require additional clarification, contact your assigned Provider Relations Representative.

  1. Contact Provider Services at HIM_PHONE
  2. If you do not receive resolution, contact your Provider Relations representative
    • Please have claims numbers/issues available
    • Your PR rep will respond to you within 48 hours
  3. If your PR rep does not respond within 48 hours, please contact the PR supervisor

If you have questions regarding billing, IlliniCare Health has a Billing Manual (PDF) for your reference.

Billing questions for Behavioral Health care services please contact claims customer service at HIM_PHONE or your Provider Relations representative.

IlliniCare Health Top 5 Global Issues. We post monthly status reports here. If you have question or concerns you may contact your Provider Relations Representative.

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IlliniCare Health routinely provides information and support for you to deliver the best quality of care.