CountyCare Health Plan

CountyCare (Cook County HealthChoice Illinois Medicaid MCO) provider services; toll-free 855-444-1661, TDD/TTY 711. Same numbers are published for Member Services.

Touch-tone automated member eligibility IVR on the provider services numbers (toll-free 855-444-1661); eligibility also via the provider portal or state MEDI system.

Paper medical claims mailing address and electronic Payer ID 06541 (provider manual 09.08.26). Timely filing 180 days; claim reviews/disputes/appeals within 60 days of EOP. Dental claims go to Avesis.

PA questions and phone requests; requests also through the secure portal (Identifi/Availity).

Fax the Inpatient Prior Authorization Form.

Fax the Outpatient Prior Authorization Form (manual also lists this fax for medical pharmacy).

Fax the Behavioral Health Authorization Form.

Adult medical oncology, cardiology, radiology or radiation oncology authorization requests (option 1); online via the Evolent/New Century portal.

Request via RadMD or by phone per the provider manual.

All pharmacy and specialty pharmacy PA requests: fax the Caremark Medication Request Form or Universal PA Form. Pharmacy help desk number differs between pages (1-833-845-4702 vs 1-800-364-6331) and is omitted.

Dental prior authorization via the Avesis portal or phone.

Vision prior authorization via portal or phone.

Provider complaints about policies, procedures or administrative functions in writing; disputes also via the provider dispute portal process.

Report incidents (abuse, neglect, exploitation) involving CountyCare members using the incident form by phone, fax or email.