Illinois
As the behavioral health vendor for IlliniCare, one of the two HMO’s recently selected by the Illinois Department of Healthcare and Family Services (HFS) for the Integrated Care Program membership, Cenpatico is currently contracting IlliniCare’s behavioral/substance abuse provider network. IlliniCare’s membership includes Older Adults and Adults aged 19 and over with disabilities who are eligible for Medicaid but are not eligible for Medicare.
Benefits of Cenpatico network participation include;
- Timely claims payment & online claims submission functionality
- Flexible authorization processes
- Online member eligibility verification
- Care coordination services
- Comprehensive training materials
- E-Learning and CEU credit opportunities at no charge to you
- Participation in advisory committees, etc., upon your interest
- CAQH credentialing applications accepted
Please note that a Medicaid Number is required to join our network.
If you would like to join our Illinois network, please click here to send us an email with the following information:
- Organization Name
- Name and Contact Information
- Brief Description of Services Offered
- Medicaid Number
Provider Manual
Outpatient Treatment Request (OTR)
- Illinois Outpatient Treatment Request (OTR) Form
- Illinois Outpatient Treatment Request – Training Presentation
- Illinois Outpatient Treatment Request Tips Sheet
- Illinois Intensive Outpatient/Day Treatment Form – Chemical Dependency and Mental Health
Psychological Testing Forms
Electroconvulsive Therapy Form
Administrative and Claims
- CMS-1500 Claim Form Instructions (HCFA)
- PCP Communication Form
- Provider Change Form
- Provider Complaint Form
- UB-04 Claim Form Instructions
- W-9 (must accompany Change of Address Form)
Clinical
Quick Reference Guides (QRG)
Frequently Asked Questions (FAQ)
Authorization Guidelines
Medical Necessity Criteria
- 2011 Cenpatico Medical Necessity Criteria – Private Day Treatment and Community-Based Services
- *Note* – Effective February 1, 2011, Cenpatico, in association with InterQual, will begin enforcing new Medical Necessity Criteria for Behavioral Health. To see answers to Frequently Asked Questions (FAQ) regarding the change, please click here.
Best Practice Intervention Strategies Fact Sheets
To access the IlliniCare website, please click here, or click on the logo below.


