Ill. HFS Handbook for Hospice Agencies, Topic K-260.3

Refer to Chapter 100 for general policy and procedures regarding claim submittal.

Any services that do not require attachments or accompanying documentation may

be billed electronically. Further information concerning electronic claims submittal

can be found in Chapter 300, 5010 Companion Guide.

Providers billing electronically should take special note of the requirement that Form

HFS 194-M-C, Billing Certification Form, must be signed and retained by the

provider for a period of three (3) years from the date of the voucher. Failure to do so

may result in revocation of the provider’s right to bill electronically, recovery of

monies or other adverse actions. Form HFS 194-M-C can be found on the last page

of each Remittance Advice that reports the disposition of any electronic claims.

Refer to Chapter 100 for further details.

Please note that the specifications for electronic claims billing are not the same as

those for paper claims. Please follow the instructions for the medium being used. If a

problem occurs with electronic billing, providers should contact the Department in

the same manner as would be applicable to a paper claim. It may be necessary for

providers to contact their software vendor if the Department determines that the

service rejections are being caused by the submission of incorrect or invalid data.