Provider Information

Primary Care Extension Program Summit: June 17, 2011

The primary care extension program (PCEP) is a model of care that was developed to take advantage of community networks as a means of improving quality of medical care and community health through two mechanisms, namely, local technical support of practices and linkage with community resources. PCEP is a framework of care intended to support a variety of models of practice. Optimal effectiveness is likely to come when PCEP is aligned with primary care practices based on patient-centered medical home model (PCMH). The PCEP model provides assistance for the transformation of primary care to the medical home model. While the medical home model represents an improvement in health care delivery and outcomes, unaddressed social determinants of health often impact a patient’s ability to follow through on his or her care plan. Public health programming may be able to impact some of these barriers with the use of lay health workers who straddle the gap between the patient in the community and the medical practice. The PCEP model incorporates Health Extension Agents (HEAs) to perform this outreach function. While the Affordable Care Act (ACA) calls for the development of a national PCEP framework, funding has not been allocated. On June 17, 2011, Illinois Health Connect hosted a state-wide Summit to explore the PCEP concept and opportunities for creating a PCEP network in Illinois.

Please review the links below for information about the Summit. For additional questions, contact Margaret Kirkegaard, MD, MPH, Illinois Health Connect Medical Director at [email protected]

Preconference Readings

Summit Agenda

Speaker Presentations

Environmental Surveys

  1. Aggressive Lipid Management and Cardiovascular Risk Reduction for Primary and Secondary Cardiovascular Prevention
  2. Office of the Future/PEDS CARE
  3. Illinois Area Health Education Centers Network Program
  4. Bright Smiles from Birth
  5. (CHIPRA) Quality Demonstration Project
  6. Enhancing Developmentally Oriented Primary Care
  7. Building Community Based Medical Homes for Children Program
  8. Promoting Health
  9. Immunization Initiatives

PCEP Photos

IHC Referral Video

To continue the ongoing efforts to "connect" Illinois Health Connect (IHC) patients with their medical home and support continuity of care, IHC implemented Phase I of the Illinois Health Connect Referral System. Implementation was completed in stages by geographic region. Phase I was effective statewide on April 1, 2010.

Phase I requires IHC patients to see their own IHC PCP, or a provider or clinic affiliated with their PCP. PCPs seeing IHC patients who are NOT enrolled on their panel or on an affiliated PCP's panel on the date of service, must obtain a referral from the patient's PCP in order to be reimbursed by HFS for services provided. PCPs are able to submit referrals for their IHC patients to see other IHC PCPs through the IHC Provider Portal via the secure HFS MEDI system and directly with IHC via fax or phone. Specialists will not require a referral to ensure payment in Phase I. IHC PCPs will be able to post-date a referral up to 60 days from the date of service.

Watch a seven minute video about the IHC Phase I Referral policies and procedures for entering and verifying referrals.


Watch the Referral Video

IHC Informational Video

Watch a brief informational video about Illinois Health Connect and the resources Illinois Health Connect can provide to your practice.


Watch the Informational Video

IHC Overview and Updates

Click on the PowerPoint presentation below to learn more about the Illinois Health Connect program and any recent changes that have been implemented. Also, check back soon for a complementary audio presentation!

View PowerPoint

Important Notices

Date Topic
1/10/2012 Common Questions and Answers on the IHC Client FAQ
12/14/2011 PCP Verification and Excluded Populations memo
4/4/2011 2011 IHC PCP Survey
3/17/2011 DCFS Clients with an Assigned PCP
3/4/2011 IHC Bonus Payment Program 2011
09/27/2010 Specialty Care provided by IHC PCPs
08/10/2010 Improving Care for Children
07/20/2010 Adult Immunizations
06/11/2010 Smoking Cessation
05/20/2010 IHC PCP Changes Via the Web/Phone – In PCP Office
05/14/2010 Referrals and Billing IHC Patients
04/23/2010 Client Enrollment Policy
04/14/2010 HFS Asthma Billing Guidelines and Education
03/09/2010 PCP Verification and Excluded Populations
2/10/2010 I-CARE and Immunization Data
10/01/2009 School-based Clinics Referral and Direct Access Billing Requirements
10/01/2009 RHC & ERC’s Referral and Direct Access Billing Requirements
10/01/2009 FQHC Referral and Direct Access Billing Requirements
10/01/2009 Physician, APN, & Hospital Referral and Direct Access Billing Requirements
9/16/2009 2009 IHC Provider Satisfaction Survey Results
8/26/2009 Billing Co-Payments Q&A
8/3/2009 Informational Facsimile of the IHC Referral System
8/3/2009 IHC Referral System Implementation
2/24/2009 Increased Rates for E/M Visits
2/2/2009 Increases to Reimbursement for Physician Services

Important Forms

05/17/2011 Initiated Request for Client Reassignment Form
05/13/2011 Panel Restriction Change Form
05/07/2010 Provider Initiated Request to Add an Affiliation (Differing Group)
05/07/2010 Provider Initiated Request to Add an Affiliation (Single Group)
10/01/2009 Provider Referral Fax Form

Illinois Health Connect is Illinois’ Primary Care Case Management (PCCM) program. In Illinois Health Connect, most people with an HFS or All Kids medical card will have a medical home through a Primary Care Provider (PCP).

Through the services of Automated Health Systems (AHS), eligible participants (predominantly parents and children, All Kids members and adults with disabilities) will choose a PCP who will manage their care, provide immunizations and other primary and preventive health care services and help avoid unnecessary emergency room visits and hospitalizations. PCPs will make referrals for additional care when needed.

Here is some General Program Information for Providers regarding Illinois Health Connect.

You can also download the Illinois Health Connect Primary Care Provider Handbook.

Here is some information concerning client enrollment by county.

How do I enroll as an Illinois Health Connect PCP?

It's easy. Physicians, Clinics, and Health Centers who wish to enroll in Illinois Health Connect as a Primary Care Provider can simply call the Illinois Health Connect Provider Services Helpdesk at 1-877-912-1999 (TTY: 1-866-565-8577). The call is free. The hours of operation for the Provider Services Helpdesk are Monday – Friday 8:00a.m. to 7:00p.m. We can send an application to you and/or have one of our Provider Service Representatives schedule a convenient time to meet with you, answer all of your questions and help you enroll.

Here is a document that has answers to frequently answered questions for providers.

Providers can also enroll online as an Illinois Health Connect PCP.

MEDI Training Materials

Provider Access/MEDI