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Updated: 24 August 2026

Illinois Workflow

Overview 

(As always, private pay is generally self-regulating within the confines of state law and regulatory processes. This article focuses on Medicaid billing in the state of Illinois.) 

 

In the state of Illinois, there are some unique billing processes. This is because select Medicaid visits must be completed using electronic visit verification (EVV), and these verified visits are required to be sent Sandata. Certain MCO users will instead be required to be sent to HHAx if applicable effective March 2026. For Ankota users, that means in addition to our regular EVV services which we provide, we also deliver appropriate visit data to the appropriate location to ensure your state's requirements are met. This article will help guide you through this process.


Note we are currently sending categories DHS/DRS and Elderly DoA to Sandata.

 

This article covers:

Set-up

General Resources

Sandata Set-up

HHAX Set-up

Testing

HHAX Testing

Pre-Billing

Billing Management for Medicaid Visits

HHAX Billing

Remittance Advice Management (835s)

Corrected Claims

HHAX Claim Correction

Further Details

 

Set-up

General Resources

CRITICAL NOTE: Customers must complete their registration with Sandata and HHAX with Ankota listed as their alternate EVV provider in order for Ankota to connect and deliver EVV data to them. No data delivery can be completed without this completed registration.


Sandata Set-up

Programs/Visit Plan Categories DHS/DRS and Elderly DoA go to Sandata.


Registration

  • First, create a new log-in by going to https://sandata.zendesk.com/auth/v2/login/signin and clicking “sign up”

  • Once you are logged in, click “Submit a Request” to access the request webform

  • Finally, complete a webform request to register Ankota as your EVV vendor

    • We recommend you include your company name and IDs in the Description section of the reques 


Caregiver & Client Requirements



HHAX Set-up

Most visit types will be exported to HHAeXchange. Tasks 115-511 must also be sent to HHAX.


Visit Types Required

T1002, T1003, T1020, G0151, G0151 U2, G0152, G0152 U2, G0153, G0153, G0153 U2, G0299, G0299 U2, G0300, T1002, T1002 TU, T1002 TT, T1002 CR, T1003, T1003 TU, T1003 TT, T1003 CR, T1004 TU, T1004, T1005 TD TT, T1005 TE TT, T1005 TD, T1005 TE, S5150, G0299, G0299 U2, G0300, T1002, T1002 TU, T1002 TT, T1002 CR, T1003, T1003 TU, T1003 TT, T1003 CR, T1004, T1004 TU, T1005 TD TT, T1005 TE TT, T1005 TD, T1005 TE, S5150, G0299, G0299 U2, G0300, G0151 U2, G0151, G0152 U2, G0152, G0153 U2, G0153, T1002, T1003, T1020, T1002, T1003, T1020, T1002, T1003, T1020, G0151, G0151 U2, G0152, G0152 U2, G0153, G0153 U2, G0299, G0299 U2, G0300

Updated as of June 2024


Care Plan Items


In short, those services are subject to the EVV mandate and must be delivered to HHAX. Internally, Ankota users are automatically set up for delivery of EVV visit data to the state as part of implementation, but registration ensures HHAeXchange will accept the data and give providers access to credentials and the HHAeXchange log-in. 

 

Registration

To register with HHAeXchange, go to Third Party EVV Attestation - IL. You will need the following information:

  • Provider name: YOUR COMPANY NAME

  • Provider contact name and email address: NAME, EMAIL

  • Provider Medicaid ID:

  • Provider Tax ID:

  • Vendor name:  Ankota LLC

  • Vendor address:  1 Franklin Street, Suite 360B, Boston, MA 02110

  • Vendor contact name & contact information:  Sharon Dodge, COO, sharon.dodge@ankota.com, 844-4-Ankota, extension 703

  • If you want HHAx to bill your data, request that option


Questions about IL EVV can be sent to dhs.evv@illinois.gov. Additional questions about HHAeXchange can be sent through the HHAX portal or call (866) 245-8337.

 

Credentials

HHAeXchange will provide credentials in return. Please send Ankota the following information so that your data can flow to the state:

  • Your HHAeXchange credentials

  • Any HHAeXchange communications

  • Your provider Medicaid ID, Tax ID, and taxonomy codes

 

Required Data

Illinois collects the following information (this is the information that MUST be added to your system prior to data delivery):

  • Type of service

  • Person Serviced

  • Dates of Service

  • Location of Service

  • (Reason & Action codes if needed)

  • Payer

    • Note Illinois does NOT require program specifics

  • Name of Caregiver

  • Times of Service (start & end time)

  • Client data

    • First Name Last Name

    • Medicaid ID in the Medicaid ID field

      • OR ALTERNATE non-Medicaid ID in the second client ID field

    • Client address

    • Primary diagnosis code (this must be the diagnosis CODE, not the description, and it must be the code assigned by the state, not a general valid diagnosis code)

    • Relationship to insured

    • Plan Assignment (Medicaid, Blue Cross/Blue Shield, Champus, Commercial Insurance Co. Medicare Part B, Medicaid)

  • Caregiver demographic data

    • First Name Last Name

    • DOB

    • SSN

    • Gender

    • Hire Date

    • ID & Matching Caregiver Code (do not skip the code UNLESS you do not want the caregiver to send, like the Ankota Support caregiver)

      • Professional license number if possible

    • Gender

    • Role for Type: ‘Both’, ‘Skilled’, or ‘Non-Skilled’ (this is under Roles)

      • no other Role is allowed by HHAx

    • Hire date

    • Valid email and phone format (if email and phone are entered)

    • Valid Address (State and 5-digit ZIP required)


Please note you can not send visit data until caregivers are successfully sent and received. Please also make sure your clients are on file with the state/HHAx per your payer. Per HHAx, "If you do not accept the [client] placements within a certain time frame they go to a pending queue...You do need to have someone check the system daily to accept new placements." You can email HHAx if you need them to re-set the clients to pending. Please also note clients must have active authorizations in order for clients' data to be accepted.

 

Testing

HHAX Testing

No state testing processes are required for individual vendors at this time.

 

Pre-Billing

Successful billing starts at the beginning of the client's creation. The processes below will lead to successful billing. 

  • Finally, manage your rejections


The Landing Dashboard will highlight necessary actions, including managing visits as needed.


Billing Management for Medicaid Visits

HHAX Billing

Currently, the following services require EVV management and are sent to HHAeXchange. More information is available here. Please note group homes, DDD Supported Living Services (24-hour service), and self-directed personal care services do not require EVV at this time.


This process works as follows:

 

Remittance Advice Management (835s)

Remittance advice files, or 835s, may be provided in response to filing Medicaid claims. Think of these like state receipts of payments. If you are provided with these files, they can be uploaded to Ankota for an automatic application of payments in the A/R records. For more on this process, see below.

 

 

Corrected Claims

Generally, claims corrections are handled one of two ways:

  • Update the claims in Ankota and re-send

  • Update the claims in the location where it was sent 


HHAX Claim Correction

To correct claims that were rejected in HHAeXchange,


Further Details

These additional resources may also be of use: