Communication Alert - Social Services Package B Status
As you may be aware, the state is in the process of migrating to a new Integrated Eligibility System (IES). In preparation for Phase 1 of this project, HFS and DHS MIS made changes to the recipient database that resulted in some individuals' eligibility for Social Services Package B being cancelled. This in turn has resulted in the rejection of some claims for DMH services submitted to HFS between March 31st, 2015 and April 8th, 2015. HFS has now instituted a "hold status" for all claims received from today forward. This "hold" status will be applied until Social Services Package B status has been reactivated. Because claims placed on "hold" are not being processed, these claims should not reject because of Social Service Package B status once regular processing is re-initiated by HFS.
HFS and DHS MIS are currently working to remediate this issue as soon as possible by reactivating Social Services Package B for the individuals impacted. DMH has been told that the cases will be reactivated by Friday close of business. Once this task has been completed, the claims placed on hold will be released for processing.
Until the remediation process is completed, the following actions are recommended:
- Hold submission of registrations and re-registrations until notification that social services package B status has been reactivated by DHS MIS and HFS. As you know, active RINs and Social Services Package B status are required for registration. Submission of registrations without this status will result in errors.
- Review the registration response reports generated by the Collaborative in response to your registration batch and ProviderConnect registration submissions to ensure that the registrations that were submitted between March 31st and April 8th were accepted. The DMH Collaborative system did not change, however due diligence suggests that agencies check to verify that the registrations submitted during this time period were accepted given the Social Services Package B issue described above.
- Review remittance advice received from HFS for claims submitted between the dates of March 31, 2015 and April 8th. Claims rejected because of Social Services Package B only issues for individuals who had social services package B status assigned will need to be resubmitted. As noted above, HFS has now placed a hold on claims submitted today forward, however some claims submitted earlier today April 8th may have been rejected.
Once DMH receives notification from HFS and DHS MIS that Social Services Package B status has been reactivated for individuals for whom DMH purchases services, a communication alert will be sent to DMH providers to advise that this issue has been remediated.
Mary E. Smith, Ph.D.
Decision Support, Research and Evaluation
Division of Mental Health
Illinois Department of Human Services