MedicaidAdministrativeHigh impact
Discontinuation of Dual Processing
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
May 1, 2012
We identified it
Jun 20, 2026
Summary
Illinois Medicaid will stop accepting older 4010 format EDI transactions and only accept HIPAA 5010 format starting May 1, 2012. All claim submissions, eligibility checks, and status inquiries must use the newer 5010 format or they will be rejected.
Action Required
By April 30, 2012: Billing team must contact their clearinghouse and billing software vendor to ensure all EDI transactions (claims, eligibility checks, claim status requests) are being submitted in HIPAA 5010 format instead of 4010 format. Update billing system settings and test submissions before May 1st deadline. Claims submitted in old 4010 format will be rejected after April 30, 2012.