Seniors and Persons with Disabilities. Company Overview. Parent Company Established in 1995 Serving TANF Population Over 85,000 enrollees Non-for Profit. Wholly Owned Subsidiary of FHN Serving SPD Population ICP expansion plan in Rockford & Chicago
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Not-for-profit created in 1995 by five safety-net hospitals
State of Illinois
Medicaid: Temporary Assistance for Needy Families (TANF)
Seeking a better alternative for Medicaid health care and financing, Family Health Network joined with the following allies to develop CCAI:
• Access Living of Metropolitan Chicago, a nationally recognized advocacy group for people with disabilities
• Health & Medicine Policy Research Group, an independent policy center that conducts research, educates and collaborates with other groups to advocate policies and impact health systems to improve the health status of all people
• Sinai Health System and Schwab Rehabilitation Hospital recognized as national models for urban health care delivery
The Community Care Alliance of Illinois is a health plan dedicated to consumer-directed, community-based innovative health services specializing in the care of Seniors & Persons with Disabilities.
To be the leader in Choice, Access, and Quality of Health Services for the people we serve
Person Centered with Six Domains
Disability Competent Primary Care
MD/DO- family medicine, internal medicine, pediatrics
PCP Yes, enrollee wishes to continue current relationship with PCP
PCP No, assigned to NP PCP
Monthly meetings Consultation
Fully accessible and user-friendly environment for people with disabilities and complex needs, Anchor Medical Homes will provide the following:
Agree to jointly hire, develop collaborative agreements for NP’s
CCAI works to uphold the following
Authorizations: Physicians and Hospital providers may request Authorizations from our Utilization Management Team. Authorizations may be obtained via:
Telephone @ 866-871-2305
The web portal @ www.ccaillinois.com (only for outpatient services)
Fax @ 312-491-9856
Services Requiring Authorization:
What services DO NOTrequire a prior authorization?
All mental health and substance abuse (MHSA) services are sub-contracted to a PsycHealth. PsycHealth manages both inpatient and outpatient services, as well as all UM processes related to MHSA.
1121 Florence Ave., 2nd Floor
Evanston, Illinois 60202
(on the Member ID Card) or visit the CCAI website and click the CVS Caremark
button on our Home Page to find a participating pharmacy nearby.
Mail Order Option:
Prescriptions will be filled for up to a 30-day supply in the pharmacy. Enrollees who need long-term medication can send their prescriptions to CVS Caremark’s mail-order pharmacy at
PO BOX 94467
PALATINE, IL 60094-4467
Formulary, PA and Step Therapy:
CCAI utilizes a Preferred Drug List, which can be found on the CCAI website. There are medications that require Prior Authorization or are only accessible through Step Therapy. These, along with instructions for obtaining authorization, can be found by calling the CVS Caremark Customer Care Line at (855)248-3446.
The enrollee’s ID number is the same as their Medicaid ID number
Timely Filing Guidelines
Claims Instructions: CCAI follows CMS guidelines
Submission of Corrected Claims:
Claim Appeals or Disputes:
Community Care Alliance
C/0 Appeals Dept.
322 S. Green Street #400
Chicago, Illinois 60607
The following items will cause a claim to be rejected prior to processing:
Missing any of the following fields:
Rejected claims will be returned to the provider along with an applicable explanation
Community Care Alliance of Illinois
P.O. Box 294
4064 N. Lincoln Avenue
Chicago, Illinois 60618
Please contact 866-871-2305with claim inquiries
Timely and accurate claims payment
Access to the CCAI Web Portal
Access to the CCAI Secure Web Portal
Please visit us at www.ccaillinois.com and register today!
What is Abuse?
-Emotional or Mental Abuse
What are the Reporting Requirements?
When Should You Report to the Hotline Number?
Whenever you believe that an individual with disabilities or an older adult has been abused or neglected. Some examples of abuse or neglect :
Where should you report Abuse or Neglect?
The Office of Inspector General at 1-800-368-1463
Adults with disabilities 18-59 years of age or someone with Developmental Disabilities
The Elder Abuse Hotline at 1-866-800-1409
Adults 60 years of age and older
Illinois Department of Public Health Hotline at 1-800-252-4343
Complaints against long-term care facilities
Senior Helpline: 1-800-252-8966
Abuse, neglect, exploitation of an adult 60 years of age older in a Nursing Home
Supportive Living Facility (SLF): 1-800-226-0768
Enrollees residing in SLFs
Community Care Alliance of Illinois at 1-866-871-2305