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

  Hospital Education Resources 

Coding Job Aids

Hospital Contact Form

Definitions and FAQs

Review Request Forms

Flow Charts

Utilization Review Manual
General Education Presentations Web User Guides

Want More Educational Resources?

 Click Here for Recommended Links

 

Coding Job Aids

These coding job aids are the ICD-9-CM diagnosis codes from Attachments A, B, and C sorted numerically and alphabetically. Effective with admissions on or after June 1, 2008.

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   Definitions and FAQs

This document provides general explanations of common terms and questions about the utilization review process.

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Flow Charts

These documents provide a visual explanation of specific review processes.

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   General Education Presentation

  • Retrospective Review presentation slides (.pdf) added 7/30/2008
         An overview of the review process for pre- and post-payment review, explaining the various timeframes for processing and completing reviews and the information needed when submitting medical record copies.

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Hospital Contact Form  

It is important to notify HSI immediately when contacts change to ensure timely communications.  Please use this new form when updating contact information for a HSI liaison, quality contact and/or Web administrator.

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Review Request Forms

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

Admission Certification Review Request Form Instruction
Continued Stay Review Request Form Instruction
Psychiatric Admission Certification Review Request Form Instruction
Psychiatric Continued Stay Review Request Form Instruction
Reconsideration Request Form Instruction
DRG Change Reassessment Request Form Instruction

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Utilization Review Manual

A comprehensive guide for HFS' utilization review program.

Web User Guides

These documents provide useful visual guides for participants using the Web Review System. Click here to register for the next training session.  

  SPECIAL SECTION - ON THE WEB

Summary of Provider Web Reports (.pdf)

A helpful visual guide of the report inquiry feature allowing hospitals to obtain real-time status of HSI reviews.

User Maintenance Guide (.pdf)

Resource guide for User Maintenance Module used by HSI Web Administrators.

Web User Guide (.pdf)

Complete resource guide on how to enter a Web review.

Web Review Screen Examples (.pdf)

View screen shots of the Web review submission process.

Web Review System Features (.pdf)

List of the latest features of Web Review System.

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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  
- Provider Updates & HFS Notices
- Physician Reviewer Information
- Recommended Links
For SASS Providers & CARES

About HSI
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Web Review System
 - Submit Review Requests
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 - 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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