Illinois is home to more than 40,000 physicians and a healthcare market shaped by Chicago’s massive medical infrastructure, a sprawling Medicaid managed care program, and a commercial payer landscape where Blue Cross Blue Shield of Illinois holds dominant market share. Billing correctly in Illinois means understanding BCBS IL’s specific rules, navigating the state’s Medicaid managed care organizations, and staying current with Illinois regulatory requirements. Go Medical Billing serves practices across the Chicago metro, suburbs, and downstate Illinois.
Illinois Medicaid Managed Care
Illinois routes most Medicaid beneficiaries through managed care plans including Meridian, Molina, Blue Cross Community, CountyCare (Cook County), and IlliniCare. Each plan has its own enrollment requirements, authorization rules, and claims processes. We handle Illinois Medicaid billing and credentialing across all plans.
Blue Cross Blue Shield of Illinois
BCBS IL is the largest commercial payer in the state by a wide margin. Their provider portal, claims edits, and authorization requirements are specific to the Illinois plan. Our team processes BCBS IL claims daily and knows their system thoroughly.
Medicare in Illinois
Medicare claims in Illinois are processed by Novitas Solutions (Part B) and CGS Administrators (DME). Each MAC has specific LCD and NCD policies that affect coverage determinations. Our coders apply the correct MAC specific rules to every Illinois Medicare claim.
Illinois Insurance Regulation
The Illinois Department of Insurance enforces state specific prompt payment laws that require payers to process clean claims within 30 days. When payers miss these deadlines, we file prompt payment complaints. Illinois also has its own surprise billing protections through the Illinois Insurance Code. We ensure your billing complies with both.
Cardiology, urology, urgent care, behavioral health, orthopedics, ABA therapy, DME, laboratory, internal medicine, pain management, and more. Whether you’re in Chicago’s Loop, the western suburbs, or downstate, we handle billing for your specialty and your market.
Starting at 2.49% of net collections. In the Chicago job market, a medical biller costs $42,000 to $58,000 in salary before benefits and overhead. Our rate covers an entire billing team, coders, account managers, and A/R specialists, for less than half what a single employee costs.
Which Illinois payers do you work with?
All major Illinois payers: BCBS IL, Aetna, Cigna, UHC, Humana, Meridian, Molina, Blue Cross Community, CountyCare, IlliniCare, Medicare (Novitas), and more.
Can you handle Illinois Medicaid credentialing?
Yes. We manage enrollment with all Illinois Medicaid managed care plans, including HealthChoice Illinois and legacy Fee for Service where applicable.
Do you serve practices outside of Chicago?
Yes. We work with practices across the entire state. Downstate Illinois has a different payer mix and patient population than Chicago, and we adjust our billing approach to match your market.
Call 888 701 6090 for a free Illinois billing assessment.
