Provider Group/Group Practice

A group practice is a business that involves two or more individual providers enrolled as a DD Medicaid Waiver program to provide specialized services. The individual providers have an established cooperative practice and share resources such as a facility or administrative offices, administrative and managerial personnel, electronic systems to store client records and billing information, policies and procedures and other resources.  The Medicaid reimbursement for the individual providers are made to the group practice business and the members of the business decide how the shared income will be used. 

The Developmental Disabilities Medicaid Waiver program requires group practice businesses to register in IMPACT to be eligible to submit the billing for the individually enrolled providers.  Billing is submitted using the individual provider's enrollment information.  Therefore, the individual providers must meet the IMPACT and DD waiver enrollment requirements and be associated to the group practice as their billing provider. 

The group practice must use the DDD ROCS electronic billing software to submit the billing for the enrolled individual providers.  DD waiver services can NOT be submitted directly to HFS or a Medicaid MCO plan.

  1. Apply for a Type 2 - National Provider Identification Number (NPI) on the National Plan and Provider Enumeration System 
  2. Contact the IMPACT Help Desk and submit an IRS W-9 .
  3. AFTER your IRS W-9 has been approved, register the Group in the IMPACT Provider Enrollment system as a Group:
    1. You, person sitting at the computer to complete the enrollment application, must create an IMPACT account on the IMPACT login page. 
    2. After creating this account, you will need to apply for approval for a Single Sign-On ID.  Please use the Single Sign-On ID PowerPoint Presentation to complete this step. 
    3. When the Single Sign-On ID has been approved, return to the IMPACT login page and log into your account. 
      1. Click on NEW ENROLLMENT. 
      2. On the next screen, select the Enrollment Type:  Group
      3. Use the Group PowerPoint Presentation for guidance to complete the Group application.  This PowerPoint presentation is located at IMPACT Presentation and Materials. 
      4. Healthcare and Family Services reviews and approves Group applications.  You will receive an email notification when the Group application has been approved. 
  4. After receiving this notification, send an email to DHS.DDDMedProv@Illinois.gov to request the forms required for access to the ROCS billing system.  This system is used for ALL billing for services provided to DD Medicaid Waiver participants. 
  5. Review the information about Using ROCS and contact the ROCS helpdesk for Technical Support.