This toolkit was developed by EverThrive Illinois and the Illinois School-Based Health Alliance (ISBHA) to support Illinois school health centers (SHCs) with the transition to Medicaid managed care.
The toolkit includes background information and a catalogued list of definitions, contacts, ideas, and resource links to help SHCs more readily access SHC-specific Medicaid managed care information in one place. As appropriate, we’ve included dates and links to original sources. Please note that much of this information is subject to change. While we will do our best to update the toolkit, wherever we provide a link to a source, we recommend that you take the time to verify.
This toolkit is part of a larger policy collaborative effort, sponsored by the national School Based Health Alliance, seeking to ensure that SHCs are integrated into new and emerging financial models. We thank the national School-Based Health Alliance for their support for
this project. We also thank our partners at the Illinois Department of Healthcare and Family Services, the Illinois Department of Public Health, the ISBHA’s Steering Committee members, the various health plans and the Illinois Association of Medicaid Health Plans for their feedback.
Click on a section below to read more on a specific topic.
- HFS Contracting and Reimbursement Expectations
- Prior Authorization
- Billing by Site
- Benefits of Contracting
- Map of Managed Care Entity (MCE) service areas
- List of Dental and Vision Vendors for each Managed Care Entity (MCE)
- List of Provider Representatives at each Managed Care Entity (MCE)
- Link to HFS Provider Handbooks
- Link to HFS Provider Notices
- List of Standard Timelines for Billing Managed Care Entities (MCEs)
- Provider Credentialing Database: CAQH ProView
- Site Visit and Marketing PowerPoint
- Sample Contract Language
- Appendix - 2016 HFS Provider Notices