To:
From:
Date:
Re:
Chicagoland Specialist Providers
Kathleen DeVine – Executive Director - MyCare Chicago
February 13, 2015
MyCare Chicago Billing and Claims
Hello! MyCare is a new health plan in Chicago building a network of doctors and hospitals to care for
Chicago’s Medicaid population, including FHP and ACA adults. We are classified is an Accountable Care
Entity (ACE) and provide care coordination services to our members. Coordinated Care has been proven
to reduce the cost of unnecessary or duplicate testing and improve the quality for patients.
We are glad that you are seeing our members and helping to meet their healthcare needs. We hope that
this letter can clear up any confusion you might be having when presented with our members and
membership cards.
It is so very important that patients continue to see or are referred to doctors whom they trust. Even if
you are not directly contracted to our plan, we urge you to continue seeing our patients, as having
continuity of care is vital to maintaining population health.
Please be assured that all Medicaid covered services will continue to be covered by the
state. This applies to all Medicaid patients, including those in plans to which you don’t
belong. Please bill claims to the state as you did prior to the ACE program.
(Please see the attached note from HFS on the ACE program, eligibility, and billing.)
Below is information about MyCare Chicago and assistance for you and your staff in
serving MyCare members that come to your practice.
Information and Resources for Physicians and Staff
 The ACE is responsible for coordinating care. Please work with the Care Coordinators if
they call. You can refer high-risk patients to the Care Coordinators.
 Please remember to bill directly to the state of Illinois (HFS) for the next 18 months
using the HFS number (RIN) on the members card.
 A sample of the MyCare Chicago health plan card that members (new patients) may
present is at the end of this document.
 Members of MyCare will continue to receive all of the benefits they had under their HFS
medical card including vision and dental options.
 MyCare Chicago members do not need referrals to see specialists. This includes out-ofnetwork specialists.

MyCare is owned and operated by 11 health care provider entities:
o Ann & Robert H. Lurie Children’s Hospital of Chicago, Swedish Covenant
Hospital, Mercy Hospital and Medical Center and Norwegian American Hospital.
o Asian Human Services Family Health Center, Erie Family Health Center,
Heartland Health Centers, Mercy Family Health Center, Near North Health
Service Corporation, PCC Community Wellness Center at Norwegian are
founding members. Lurie Children’s Uptown and Lincoln Park Clinics, Swedish
Covenant Medical Group and Infant Welfare Society are also PCP sites.
5145 North California . Chicago . Il . 60625
www.mycarechicago.org
o

Community Counseling Centers of Chicago (C4). PsycHealth will provide care
coordination for behavioral and mental health concerns.
ACEs are all owned by providers and take a data driven approach to managing quality
and cost by bring healthcare providers together through shared data and processes to
better serve the growing population of Medicaid patients.
MyCare Member Card
*Please use the HFS Number (Medicaid RIN) for billing purposes.
-We have also included a phone number for the Primary Care Provider and our Help Line.
5145 North California . Chicago . Il . 60625
www.mycarechicago.org
Accountable Care Entity Definition
From the IL Department of Healthcare and Family Services
http://www.isds.org/newsroom/articles/CareCoor.pdf
These entities are provider‐based organizations that will be paid a fee by the Department to
coordinate care for their enrollees. All Medicaid covered services will continue to be covered by
the state. Providers will need to bill the state as they do today. If services require prior approval
in the fee‐for‐service system today, they will continue to require it under ACEs. The process for
obtaining prior approval from the state remains unchanged. Providers with enrollees in an ACE
should work with the ACE’s Care Team to coordinate care for these individuals. Illinois Health
Connect PCPs will continue to receive monthly PCP fees for ACE enrollees. The Department
electronic eligibility systems will state “no MCO information for this inquiry” and will clearly
identify the ACE in which an individual is enrolled under the ‘Accountable Care Entity segment."
Important phone numbers:
 Customer Service Line for eligibility and other questions – 1-(844) 320-CARE(2273)
 Care Coordination Services -1 (312) 561-2551
 Enrollment Broker - 1-(866) 565-8576 or www.enrollhfs.illinois.gov
 MyCare Chicago Website www.mycarechicago.org
 For other MyCare information, contact Eric Brilliant at 773-293-6747 x205
Our sincerest thanks for your excellent service to our members. We look forward to working
with you for years to come. Please contact us if you need any more information.
Kathleen DeVine, Executive Director
Accountable Care Chicago, LLC
5145 N. California Ave
Chicago, Il 60625
773-293-6747
5145 North California . Chicago . Il . 60625
www.mycarechicago.org