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January 28, 2010

Illinois Health Connect Urgent Care Referral Policy for Phase I

The Illinois Department of Healthcare and Family Services issued a provider notice that clarifies during Phase I of the Illinois Health Connect (IHC) Referral System implementation, IHC primary care physicians (PCPs) may provide services to an IHC enrollee at an Urgent Care facility without obtaining a referral when:

• The IHC PCP is salaried/contracted by the Urgent Care Facility to provide medical services.
• The Urgent Care facility location is not the IHC PCPs enrolled location of service or affiliation under the IHC Program.
• The IHC PCP is providing services outside of their regular practice hours for IHC enrollees who are not enrolled on their IHC panel.