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.
Illinois Department of Human ServicesJB Pritzker, Governor · Dulce Quintero, Secretary
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