Illinois Medicaid covers roughly one in four state residents, and nearly all of them are enrolled in managed care. That makes the state’s Medicaid plans, not fee-for-service rules, the daily reality for any practice with a Medicaid panel. Add Chicago’s concentration of large systems and a dual-eligible population with its own integrated plans, and Illinois billing rewards teams that know the plan map cold.
MedPlus RCM provides medical billing, coding, credentialing, and denial management for Illinois practices of every specialty, built around the state’s actual payers and programs.
Illinois’s payer landscape
Illinois Medicaid is delivered through HealthChoice Illinois, the state’s managed care program. The statewide plans are Aetna Better Health, Blue Cross Community Health Plans (Blue Cross and Blue Shield of Illinois), Meridian Health Plan, and Molina Healthcare of Illinois, with CountyCare Health Plan serving Cook County. Dual-eligible beneficiaries are served through integrated plans that combine Medicare and Medicaid benefits.
Commercial coverage runs through Blue Cross Blue Shield of Illinois, Aetna, Cigna, UnitedHealthcare, and Humana, alongside Medicare and Medicare Advantage plans. The Chicago market in particular carries heavy system-affiliated commercial volume, so verifying the exact plan, not just the carrier, matters on every claim.
What MedPlus RCM handles for Illinois practices
- End-to-end medical billing. Charge entry, claim scrubbing, submission, payment posting, and patient billing, the full cycle.
- Medical coding. Certified coders assign current ICD-10, CPT, and HCPCS codes matched to your documentation and specialty.
- Provider credentialing and enrollment. End-to-end enrollment with HealthChoice Illinois plans, commercial payers, and Medicare, plus re-credentialing maintenance.
- Denial management and recovery. Every denial investigated to root cause, corrected, and appealed with documentation.
- A/R recovery. Aged and outstanding balances audited and pursued, including balances already written off where the appeal window is still open.
- Financial reporting. Clean claim rates, collections, denial patterns, and A/R aging visible by payer and provider.
We serve practices statewide, Chicago, Springfield, Naperville, Rockford, and Peoria, across specialties including primary care, mental and behavioral health, cardiology, orthopedics, dermatology, and physical therapy.
Results Illinois practices can check
MedPlus RCM maintains a 99% clean claim rate and keeps client accounts receivable under 30 days. Pricing is a performance-based percentage of successfully collected revenue: if you don’t get paid, we don’t get paid. We are 100% HIPAA compliant, and onboarding takes 2 to 4 weeks depending on practice size, with no disruption to your daily cash flow.
Frequently asked questions
What is HealthChoice Illinois?
HealthChoice Illinois is the state’s Medicaid managed care program. Most Medicaid members are enrolled in one of its plans, Aetna Better Health, Blue Cross Community, Meridian, Molina, or CountyCare in Cook County, and practices bill the plan, not the state.
Do you work with HealthChoice Illinois plans?
Yes. We bill Aetna Better Health, Blue Cross Community Health Plans, Meridian, Molina, and CountyCare, as well as commercial and Medicare plans.
How long does it take to switch our billing to MedPlus RCM?
Onboarding takes between 2 and 4 weeks depending on practice size, including data migration and payer clearinghouse setup.
What does MedPlus RCM charge?
A performance-based percentage of successfully collected revenue. If you don’t get paid, we don’t get paid.
Get a free financial audit
Find out where your Illinois practice is losing revenue. Request a free financial audit and our specialists will review your claims, denials, and A/R.
