Find out what our participant families can expect as we continue to roll out CarePay, our new claims processing system

We want to share our progress as we implement a new claims system and explain what this change means for you. 

In May, the Division of Specialized Care for Children (DSCC) launched our new claims processing system called CarePay. We developed CarePay to offer faster and more efficient claims processing. 

We are continuing to work through the initial rollout and its related issues. Here is what our participant families can expect and need to know: 

For Core Program Families

As we move to CarePay, you may experience some temporary delays with our claims processing. It could take up to 30 days for us to pay a claim. 

If you or your child’s provider has been waiting for a claim payment for longer than 30 days, please contact us. We can verify that we have properly received your claim submission and investigate any issues.

If you have experienced a significant delay with a claims payment, please bring it to the attention of your care coordination team so we can help you. 

For Home Care Program Families

• We are continuing to issue payments to nursing agencies at the updated 2025 rates. The rate increase received the necessary federal approvals in April, with an effective date of Jan. 1, 2025.
• We continue to work with our claims system developers on a plan for issuing “top-off” payments for adjusted claims we received between January and when CarePay went live.
• It is important for your nursing agency to double-check the accuracy of the claims it submits for reimbursement as we process these payments.

We understand that timely claims processing is important to you and your providers. We’re committed to resolving any issues as quickly as possible and ensuring you receive the support you need.

Thank you for your patience and partnership as we work through this transition.

If you have any questions or concerns, please don’t hesitate to contact us at (800) 322-3722. 

HFS has received the necessary federal approval for the Jan. 1, 2025, rate increase to take effect.

We have an important update on the rate increase for in-home nurses originally set to take effect on Jan. 1, 2025.

The Illinois Department of Healthcare and Family Services (HFS) has received the necessary federal approvals for the rate increase to take effect.

You will see the updated rates reflected on your next Prior Authorization for In-Home Shift Nursing letter (also known as the 2352).

The rate increase affects:

• Registered nurse (RN), licensed practical nurse (LPN) and certified nursing assistant (CNA) care
• In-home and facility-based respite care
• Nurse training rates

The increased rates are:

• RN, $57.78 per hour
• LPN, $48.15 per hour
• CNA, $32.10 per hour

You can find the updated rate table on our website’s Home Care Rate Table page.

The Division of Specialized Care for Children (DSCC) will begin paying nursing agencies the newly approved rate when our new CarePay claims software system goes live. We currently expect to launch CarePay in mid-May.

We are communicating with our enrolled home nursing agencies about this update as well.

After we transition to CarePay, DSCC will work with home nursing agencies to adjust payments for nursing services dating back to Jan. 1. 

If you have any questions, please reach out to your DSCC Care Coordinator. We are here to help!