IL Medicaid

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The IL Medicaid payer ID is IL621.

Illinois Medicaid 837P Companion Guide

To review Illinois Medicaid 837P electronic submission requirements, refer to the official companion guide:
https://hfs.illinois.gov/content/dam/soi/en/web/hfs/sitecollectiondocuments/837p.pdf

This guide outlines the standards and payer-specific rules for submitting professional (837P) claims to Illinois Medicaid.


Secondary Claim Submission

When sending secondary claims to IL Medicaid (Payer ID IL621), use the appropriate unique identifier to ensure accurate claim submission and processing. This helps streamline reimbursements and maintain compliance with Illinois Medicaid billing requirements.

  • For electronic (837P) claims, this value is submitted in:
    Loop 2330B, REF02 (Other Payer Secondary Identifier)

  • For paper (CMS-1500) claims, this value is submitted in:
    Box 9d

Note:
Box 9d applies only to paper claims. For electronic submissions, this information must be sent in Loop 2330B, REF02 as outlined above.

The value is made up of:

  • A 3-digit TPL (payer) code

  • A 2-digit status code

These must be entered in this order:

  • Payer code first

  • Status code second

Example

91001

  • 910 = Medicare Part B (primary payer)

  • 01 = TPL adjudicated (payment information included)

Important

  • The order matters — payer code must come before the status code

  • Reversing the order will result in claim rejections

  • Do not include spaces, dashes, or separators

  • Enter the value as one continuous number

Additional Notes

  • This applies when another insurance payer has processed the claim before Illinois Medicaid

  • TPL (Third Party Liability) codes and status codes are maintained by Illinois Medicaid (HFS)

  • Always verify that both codes are current and valid

References

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