HealthSystems of Illinois, NFP
The Medicaid Quality Improvement Organization (QIO) for the
State of Illinois Department of Heathcare and Family Services.


 

MARCH EDUCATION SESSION: RETROSPECTIVE REVIEW PROCESS
General education session for new staff or third-parties with responsibilities for
utilization review, case management, medical records and patient accounts.

Sign up for one of our free sessions today! (Scroll down to Education Sessions below)


To request a change in admission date contact our Provider Helpline (800) 418-4045, Monday-Friday, 8 am to 5 pm CST.

 Do you have a change in hospital liaison, quality contact, fax number, or Web Admin? 
Click here to print:
HSI Hospital Contact Form

 

New Provider Updates

December 14, 2009: Informational Notice Reminder to Use Revised Coding Lists

Click here to view archived Provider Updates.

Education Sessions

MARCH 2010: GENERAL EDUCATION SESSION - RETROSPECTIVE REVIEW PROCESS
General education session for new staff or third-parties with responsibilities for utilization review,
case management, medical records and patient accounts. Topics covered:

 Education Session: Retrospective Review Process
March 17, 18 or 22
2:00 to 3:00 pm

Click Here to register

  • HFS review requirements – Concurrent vs Retrospective review

  • Selection of prepayment and post-payment review cases

  • Nurse vs. Physician review - process for reconsideration/reassessment

  •  Determinations and review timelines

  • Hospital process for cancelled retrospective prepayment reviews

One registration per hospital, please. Please plan for a conference-style meeting. We ask for one internet connection per facility, per session.

Web Review System Training Registration

Web Review Training Date
Tuesday, March 30
1:30 to 3:00 pm

Click Here to register

Whether you have new staff or need a refresher course on how to submit your reviews online, sign up today to take a free Web Review Training class.

Learn how easy it is to submit requests for review and additional information online, as well as check status of previously submitted Web requests, submit additional information and use Provider Web Reports.

Provider Resources


ON THE WEB

Entering Clinical Information (.pdf)
Tips and tricks to entering clinical information on Web

 

Click here to view more Hospital Education Resources


Diagnosis Codes

Coding Job Aids -  These lists contain the admitting diagnosis codes subject to review from HFS' Attachments A-C and LOOK for new codes effective with admissions on and after January 1, 2010.

To download HFS' most recent Attachments A-D, click here.

 

 

For Hospitals

Helpline (800) 418-4045
(8 a.m. - 5 p.m. Central, Monday - Friday)

Certification Line (800) 418-4033
(7 a.m. - 5 p.m. Central, Monday - Friday)

- Education & Training Registration

- Frequently Asked Questions

- Hospital Education Resources  
- Medical Record Photocopy Expense
- Provider Updates & HFS Notices
- Physician Reviewer Information
- Recommended Links

For SASS Providers & CARES

About HSI

 - Holiday Schedule
 - Employment Opportunities
 - Directions

Web Review System
 - Submit Review Requests
 - Reports and Communication
 - CMH Entry
 - The WAVE

PURS (Internal Use Only)


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2050-10 Finley Road
Lombard, IL · 60148                          General Phone: (630) 317-5100


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