Clinical Services Expansion Playbook Assists Illinois Community-Based Organizations With Implementation of Third-Party Billing
Date Posted: Thursday,
February 27, 2025
The Illinois Public Health Association (IPHA) and Medical Revenue Cycle Specialists (MRCS) have published a free playbook to help community-based organizations (CBOs) through the often time-consuming and cumbersome process of establishing third-party billing processes.
With the implementation of Illinois’ 1115 Waiver, CBOs will play a vital role in providing essential healthcare services to underserved populations. Many CBOs currently do not bill third-party payors, but they will now need to develop third-party billing procedures - quickly.
Funding for the playbook comes from the Illinois Department of Public Health (IDPH). Currently, many services provided by CBOs are funded by government or private sector grants. Most CBOs do not have the capacity to bill third-party payors, such as Medicaid, Medicare, and private insurance, usually due to a lack of internal knowledge or funding to invest in software and training.
“There is an increasing need for community-based organizations to become proficient at billing third-party payors, such as Medicaid and Medicare,” said Phil Talley, Third-Party Billing Program Manager at IPHA. “We know this guide will help community-based organizations throughout Illinois become less dependent on grant funding, more self-sufficient, and enhance their capacity to provide affordable healthcare services to the communities they serve.”
The information in the playbook is built specifically for the needs of CBOs based on a series of one-on-one consulting sessions with Illinois-based CBOs. Some of the topics covered include provider credentialing, payor contracting, medical coding, fee schedules, and more.
“This first-of-its-kind publication is going to change the future of healthcare across Illinois” said Kem Tolliver, President and CEO at MRCS. “We’re proud to partner with IPHA, who has extensive experience in this space, and help organizations flourish as they diligently work to keep their communities healthy.”
The guide is available for use by any organization in Illinois at IPHA’s Third-Party Billing webpage: https://ipha.com/programs-and-services/third-party-billing
About Illinois Public Health Association
The Illinois Public Health Association (IPHA) is the oldest and largest public health association in the State of Illinois. As one of the largest affiliates of the American Public Health Association, IPHA is widely recognized as a leader in the field of public health advocacy, health education, and promotion. With a mission to lead in the enhancement and support of the public health system and the practice of public health, focused on health equity and improved health throughout Illinois, IPHA strives for excellence through a variety of programming and advocacy efforts. More information about IPHA is available at www.ipha.com.
Source: Shane Gustafson, Morreale Communications
Founded in 2006, Morreale Communications was designed with a unique blend of journalism, government, media, and creative services to provide innovative strategic solutions for a wide variety of clients in the public and private sectors.
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