Welcome to  HealthSystems of Illinois
The Medicaid Peer Review Organization (PRO) Quality Assurance and
Utilization Review Program for the state of Illinois


Medicaid Utilization
Review Materials

Coding Job Aids  Flow Charts Medicaid Utilization Review Workshop PowerPoint Presentation
Questions & Answers Review Request Forms


Coding Job Aids
Use these narrative and descriptive lists for Attachments A, B, and C


Medicaid Utilization Review Workshop PowerPoint Presentation   (.ppt 5,387k)
NOTE: The download time may be a few minutes, depending on your computer and it's internet connection.
 To see the notes from each slide, select "View" and "Notes Page" from the Tool Bar.

Back to Top


Review Request Forms

Each PDF file form may be filled out electronically and then printed for submission.
 The forms cannot be submitted online.

Medicaid Admission Certification Review Request Form

Form   (.pdf 174k)

Instruction   (.pdf 27k)

Medicaid Concurrent/Continued Stay Review Request Form

Form   (.pdf 93k)

Instruction   (.pdf 22k)
Medicaid Psychiatric Admission Certification Review Request Form

Form   (.pdf 189k)

Instruction   (.pdf 30k)
Medicaid Psychiatric Concurrent / Continued Stay Review Request Form

Form   (.pdf 87k)

Instruction   (.pdf 26k)
Medicaid Reconsideration Request Form Form   (.pdf 49k) Instruction   (.pdf 18k)
Medicaid DRG Change Reassessment Request Form Form   (.pdf 37k) Instruction   (.pdf 18k)

Back to Top

Questions & Answers

Questions and Answers Set #1 from the Workshop   (.pdf 679k)
(Changes Made 03/15/04)

Questions and Answers Set #2 from the Workshop   (.pdf 88k)
 (Changes Made 02/28/03)

Check back for additions to these questions and answers.


Flow Charts

Admission Certification, Concurrent / Continued Stay Review Process Flow chart   (.pdf 9k)
(Added 12/30/02)

Appeals Reconsideration and Reassessment Process Flow chart   (.pdf 9k)
(Added 12/30/02)

Back to Top


  [Home]
 


This Web site is produced by HealthSystems of Illinois, under contract with the Illinois Department of Healthcare and Family Services.
HealthSystems of Illinois 2002  Reports

If you experience any problems with this site, please notify us by email. Thank you.