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To find a YouthCare provider, visit the How To Find a Provider Guide, use our Provider Search, or call 844-289-2264 or email ILYouthCare@centene.com
To find a YouthCare provider, visit the How To Find a Provider Guide, use our Provider Search, or call 844-289-2264 or email ILYouthCare@centene.com

IL YouthCare Claims From Meridian

Date: 07/16/20

Dear Providers,

YouthCare HealthChoice Illinois, administered by MeridianHealth (Meridian), is a specialty health plan designed by the Illinois Department of Healthcare and Family Services (HFS) and the Department of Children and Family Services (DCFS) to serve former youth in care. YouthCare members will reflect Meridian membership in HFS' MEDI system. You will know they are YouthCare members by their member identification card (shown below).

Image of Illinois Youth Care ID Card

Medical and pharmacy claims must be submitted to YouthCare to ensure appropriate processing and payment. Providers can contact YouthCare at:

  • Phone: 844-289-2264
  • Email: ILYouthCare@centene.com
  • Website: www.ILyouthcare.com
  • Pharmacy Help Desk: 800-971-3191

Meridian has also taken steps to assist providers through this process by doing the following:

  • If a provider calls Meridian for assistance with a YouthCare member, Meridian's staff will look up YouthCare members and warm transfer providers to the appropriate YouthCare representative.
  • If a provider submits a YouthCare claim to Meridian, the provider will receive a rejection noting "FYIC Member, send claim to Centene" with remark of "M56 - Missing/Incomplete/Invalid Payer Identifier" and a reason code of "27 - Member Not Eligible on This Date of Service." Those claims must be submitted to YouthCare for processing. A process to automatically redirect claims submitted to Meridian to YouthCare for processing is expected to be ready in August.
  • If a pharmacy submits a YouthCare member pharmacy claim to Meridian, the pharmacy will receive immediate messaging including the YouthCare BIN and PCN, directing providers to rebill to YouthCare.
  • Pharmacy and claim rejections are reviewed periodically, and the YouthCare team will reach out to providers with rejected claims to direct and educate providers on how to resubmit claims to YouthCare

Sincerely,

Meridian