Ill. HFS Handbook for Hospice Agencies, ch. K-200, Definitions

Department of Healthcare and Family Services (HFS) or “Department” – The

Department of Healthcare and Family Services (HFS) or “Department” is the agency

that administers Illinois’ Medical Assistance (Medicaid) Program, as well as other public

healthcare programs.

Document Control Number (DCN) – As identified on the HFS 194-M-2 paper

Remittance advice, a twelve-digit number assigned by the department to identify each

claim that is submitted by a provider. The format is YDDDLLSSSSSS.

Y Last digit of year claim was received

DDD Julian date claim was received

LL Document Control Line Number

SSSSSS Sequential Number

HCPCS – Healthcare Common Procedure Coding System

Identification Card or Notice – The card issued by the Department to each person or

family who is eligible under Medical Assistance, All Kids, FamilyCare,

Veterans Care, Health Benefits for Workers with Disabilities (HBWD) and Qualified

Medicare Beneficiaries (QMB) who are not eligible for Medical Assistance, but are

eligible for Department consideration of Medicare coinsurance and deductibles.

Inpatient Services – Those services provided to a patient whose condition warrants

formal admission and treatment in a hospital, and that are reimbursed based on the per

diem or per discharge all-inclusive rate.

Institutional Claim format – Claims prepared in the 837I or Direct Data Entry (DDE)

electronic formats or UB-04 paper claim format.

National Provider Identifier (NPI) – The Health Insurance Portability and

Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique

identifiers for healthcare providers, payees, and health plans. For healthcare providers

and payees, this identifier is referred to as the National Provider Identifier (NPI).

Participant – A term used to identify an individual receiving coverage under one of the

Department’s medical programs. It is interchangeable with the term “recipient”.

Provider Enrollment Services (PES) – The section of the Department of Healthcare

and Family Services that is responsible for maintaining provider enrollment records.

.

Recipient Identification Number (RIN) – The nine-digit identification number unique to

the individual receiving coverage under one of the Department’s Medical Programs. It is

vital that this number be correctly entered on billings for services rendered.

Remittance Advice – A document issued by the Department which reports the status

of claims (invoices) and adjustments processed. This may also be referred to as a

voucher.