Long-term services and supports (LTSS)

Claim issue

Description of issue

Affected provider type

Call to action

Supportive living facility claims billed per the days (DA) option

Claims submitted using the DA option currently are not being processed for revenue code 240.

Supportive living facility

Provider should rebill a corrected claim using the UN (unit) option for any denied claims.

Provider should submit a new electronic claim, submission initial claims using the units option. 

Services not allowed according to provider’s contract

Claims are denied (code 60C) when Leave of Absence codes are billed with revenue code 240 during the covered days. 

Facility 

Humana will correct the issue and reprocess claims as quickly as possible.

Humana will notify providers when the issue is resolved.

Multiple months accepted for homemaker services (S5130)

Homemaker services (code S5130) claims are denied (code 338) in error when multiple months are billed on the same claim form.

Long-term services and supports (LTSS)—atypical 

Humana will correct the issue and reprocess claims as quickly as possible.

Providers should rebill corrected claims for separate months for any denied claims.

For new claims/services, providers should bill 1 month per each claim. 

Provider Documents

Illinois Medicaid

  • Illinois Medicaid
  • Illinois Medicaid Provider Notices and Updates
  • Illinois Medicaid Provider Documents
  • Illinois Medicaid Provider Training Materials
  • Illinois Medicaid Provider Long-Term Services & Support