It is the responsibility of the provider to notify the Department of any request from attorneys, insurance carriers, or participants for release of participant information or record copy services. WebCollection. Click here to keep up to date and check out IDFPR's press releases. A person who has resided in a medical institution for at least 120 calendar days is not reasonably expected to return home. If you have a good reason for not giving us this information, tell your caseworker. <>stream It looks like your browser does not have JavaScript enabled. To: Enrolled Hospitals: Chief Executive Officers: Chief Financial Officers: and Patient Accounts Managers, Re: Third Party Requests for Medicaid Patient Bills and Medical Records, _____________________________________________________________________________. Include all written documentation to support or defend that an overpayment occurred. 2P t.C4PH2P,H(+*P t,,Br5\4u LM5\+SRRK3SS~1f!^\!\ !4 Your card will have a Third Party Liability (TPL) code printed on it for each person who is covered by a third party resource. Grace B. Hou, Secretary, IDHS Help Line The Department of Healthcare and Family Services administers health insurance programs for children, pregnant women, and adults who are residents of Illinois. Mail or take your letter or appeal form to your local Department of Human Services office or mail it to IDHS, Assistance Hearing Section, 401 South Clinton Avenue, Chicago, IL 60607. <>/ProcSet[/PDF/Text]>>/Subtype/Form>>stream WebThe Bureau County Department of Human Services Family Community Resource Center Food Stamp Office, located in Princeton, IL, administers the federal Supplemental Nutrition Assistance Program (SNAP) for Princeton residents. If you qualify for medical benefits, DHS may be able to help your family pay for your funeral and burial expenses if you should die. endstream endobj Find your nearest vaccination location at, Child Care Assistance Program (CCAP) Policy Manual, Section 07 - Administrative Responsibilities, IL444-1900 - Child Care Overpayment Referral (pdf). You do not have to come to the office, but you must try to keep all your telephone appointments with your caseworker. No action will be taken to enforce the lien when you die, if your property is occupied by your spouse, your child under age 21, your child over age 21 who is blind or disabled, or in some cases, your brother or sister. 4 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form>>stream If you receive AABD cash and medical Springfield BCCD will review the Overpayment Referral and will either approve or deny the claim. Hw,JMTpuV*w5Pp In addition, the Assets are the things you own, like money in a bank account or life insurance. All overpayment inquiries shall be directed to the. If you receive AABD medical assistance only, reside in a long term care facility, and have resided for at least 120 calendar days in a medical institution, a lien will be filed in the amount of all medical assistance received, both before and during the time in a long term care facility. endobj DHS can help with this. As soon as an overpayment is identified, staff shall prepare an Overpayment Referral Packet. Children under age 19 may get medical coverage while you are waiting to find out if you qualify. Other suggestions are listed on page 2 of the Overpayment Referral form. Tell your caseworker if you have a good reason. The call is free. This is called Pay-in Spenddown. You should also tell the provider billing you that you are covered by HFS medical benefits. The Inspector General is appointed by and reports to the Governor and is confirmed by the Senate. You must also tell us if you have any other health insurance. DHS or HFS will send a letter to you if you can be repaid. Proof is a copy of any one of the following: Alien Registration Receipt Card/Permanent Resident Card/Green Card (INS-3A); Passport with the following stamps or attachments: Arrival-Departure Record with the stamp showing status (I-94), or Resident Alien Form (I-151 or I-551), or Temporary Resident Card (I-688); Other proof of lawful immigration status. Office of Inspector General is maintained within the agency, but functions as a separate, independent entity reporting directly to the governor's office. Find your nearest vaccination location at, Workers' Action Guide Chapter Table of Contents, WAG 23: Financial Adjustments and Recovery, WAG 23-05-00: Repayment of Overpayments (Cash,SNAP), WAG 23-05-02-b: Repayment - Canceled Cases, Demand Letter IntentionalSNAP Program Violation (Form 2551), Repayment Agreement IntentionalSNAP Program Violation (Form 2551A), Demand Letter Inadvertent Household Error (Form 2555), Repayment Agreement Inadvertent Household Error (Form 2555B), Demand Letter Administrative Error (Form 2556), Repayment Agreement Administrative Error (Form 2556A), if recoupment occurred on a voided Illinois Link issuance and. 09,5qVZsFII7a>B(doA!Zi.bdpgZ^4YuHz1. o;Zqy-a 0 {b' A third party may be another person, an insurance company, an organization or a program. The Illinois Department of Healthcare and Family Services (HFS) is responsible for providing healthcare coverage for adults and children who qualify for Medicaid, and for providing Child Support Services to help ensure that Illinois children receive financial support from both parents. Be sure to give your complete name and address. When this happens, HFS Medical Programs has the right, by law, to collect money from this other source to cover the bill it paid for you. The cause of each overpayment shall be classified as administrative error, client error, or provider error. You can apply in person, by mail or by fax. IDFPR announced applications for the next round of cannabis dispensary licenses will be accepted starting in January 2023. Railroad retirement and other retirement pension plans that provide health insurance coverage, Private health insurance - a health insurance policy bought from an insurance company, Group health insurance health insurance provided through an organization such as an employer, union or veterans' organization, Worker's compensation insurance coverage provided by an employer for work-related injuries, CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) - medical coverage for family members of uniformed service personnel, Court orders requiring a separated or divorced parent to provide health insurance or to pay medical costs for a dependent. To waive recovery, the heir or beneficiary must show that the recovery would cause them to become or remain eligible for programs such as Supplemental Security Income (SSI), Temporary Assistance for Needy Families (TANF) or Food Stamps. The State of Illinois has the legal right to recover assistance received through the Aid to the Aged, Blind or Disabled (AABD) program. Liens and claims are the two legal actions used to collect the amount received by AABD clients. In fiscal year 2015, more than $1.4 billion was collected in support owed to Illinois children. An overpayment shall be classified as an administrative error if the error was caused solely by actions taken by the department or its agent. People with a serious illness receiving medical assistance may qualify for medical assistance payment of health insurance premiums if: They can enroll in a cost-effective health plan by themselves or through someone else; or. At the hearing, you may represent yourself or be represented by a lawyer, relative or friend. If you withhold information or do not tell us the truth about your family income or assets, you may be guilty of fraud. Other government ID (city, county, or U.S. state issued). These programs typically center around maintaining HlSM0G? If your caseworker cannot find you, your medical benefits will stop. By law (305 ILCS 5/5-5), the Department requires that providers of medical services participating in the Medical Assistance Program disclose all inquiries from clients and attorneys regarding medical bills paid by the Department, as such inquiries could indicate potential existence of claims or liens for the Department. WebIllinois Department of Employment Security Benefit Payment Control, Overpayment Recovery and Collections 800-245-9762 If your debt has been paid in full, or if you do If you received AABD medical assistance only, resided in a long term care facility, and had been in a medical institution for more than 120 days, and a lien has been filed on your real property, a claim will be filed for the amount of all medical assistance paid, regardless of age. Call or visit your local DHS office. For example, if you get a health insurance payment for a bill HFS has paid, you must report it to your caseworker. endstream If you must choose a medical home, Illinois Health Connect or the Illinois Services Enrollment Broker will contact you. Wishing you and your families a peaceful and prosperous holiday season. A provider error includes, but is not limited to, an error that occurs when: The provider receives payment in excess of services rendered (i.e. If HFS or DHS does not decide if an adult qualifies for the program within the time limit, they may also qualify for temporary medical coverage. Home and special nursing care (only for children under 21), Rehabilitation assistance (physical therapy). H$ endstream 1-866-324-5553 TTY, 2020 Illinois Department of Human Services, Anyone, 6 months or older, is eligible to receive the COVID-19 vaccine. The Medical Assistance and Third Party Liability brochure explains how medical assistance works with other groups, known as third parties, to pay your medical bills. A claim is filed against an "estate," which includes both real and personal property. Springfield, IL United States. Works with the Bureau of Investigations, the Illinois State Police, and the Attorney General. The call is free. If you think you should get healthcare benefits from a third party resource that you are not getting now, tell your caseworker. Child support services are available to all families, regardless of income, and to either parent. H$M A caseworker at the office will answer the questions you have. Happy Holidays from Secretary Grace Hou and IDHS! Grace B. Hou, Secretary. The provider bills for children no longer in their care; The provider bills for full time care when the children were only eligible for or attended part time care; The provider inaccurately reports his or her relationship to the child or the location at which care is given; The provider bills for more days than the child is approved; or. By administrative rule 89 Ill. Admin. 10 0 obj If you received AABD medical assistance only, a claim will be filed for the amount of medical assistance paid after your 55th birthday. 2P t.C4PH2P,H(+*P ,Mt -LBr4SRCJK4C\C $ If you do not share this information, you will not get medical benefits. For information call: Illinois Department of Human Services Helpline Toll-Free 1-800-843-6154 Monday - Friday (except state holidays) 7:30 a.m. - 7 p.m. Are a U.S. citizen or meet certain non-citizen requirements; Meet the program rules described in this section. The Division of Medical Programs administers and, in conjunction with the federal government, funds medical services provided to about 25 percent of the states population. WebCollection Agency Registration Collection Agency Branch Office Registration Personal/Employment History Collection Agency Financial Statement Collection Save copies of any medical bills you paid after your time limit. @~b0E,el8[R$;inx8R+pSxwChE?7. Hr As long as you are eligible for the Medical Assistance Program, you will receive a medical card. JB Pritzker, Governor Theresa Eagleson, Director. If you do not know where your local DHS office is or you are unable to go to the office, call: Illinois Department of Human ServicesBureau of Provider Assistance & Correspondence100 South Grand Avenue, EastSpringfield, Illinois 62762, JB Pritzker, Governor Theresa Eagleson, Director. Persons using a TTY can call 1-866-565-8577. Please turn on JavaScript and try again. Ensures all collection documents and forms are completed, timely, and processed through the Automated Case Management System (ACM), when needed. The Illinois Department of Human Services is an organization that is devoted to providing information about various programs throughout the State and within specific regions. 3 0 obj At this point, IDHS Bureau of Collections establishes the debt in CARS, issues the second and subsequent overpayment letters, and collects the payments. The call is free. Hr This notice serves as a reminder that hospitals must inform the Department of all third party requests for paid claim information and medical records for patients who receive medical coverage under the Department's Medical Programs. Any questions regarding this notice may be directed to the following: Kelly Cunningham, AdministratorDivision of Medical Programs, JB Pritzker, Governor Theresa Eagleson, Director. You can also fill it out, sign it, and leave it at the FCRC. Code Section 140.12(g), the provider agrees to furnish to the Department, in the form and manner requested by it, any information it requests regarding payments for providing goods or services, or in connection with the rendering of goods or services or supplies to recipients by the provider, his agent, employer or employee. Canceled for receipt of UI benefits and receipt of past unreported UI benefits is known or suspected and verifications have been requested by the Family Community Resource Center. Our vision is that all Pennsylvanians live safe, healthy, and independent lives, free of discrimination and inequity. 1-800-843-6154 Sometimes HFS pays a medical bill that someone else or other insurance should have paid for you. endobj The agency is organized into two major divisions, WebIllinois State-Human Service Department. If you are a patient in a hospital, ask someone on the hospital staff to help you apply. JB Pritzker, Governor Theresa Eagleson, Director. H,N07GFbCd>~2VU!g|A+ 3rN9=%s&?FG'SIq jQGZ.6,E{ & Where the overpayment period is over 15 months old and the information is not available in the case record. If you receive medical assistance and you get money from a third party resource for a medical service that medical assistance already paid money for, you must repay the state of Illinois. The form is available at all local Department of Human Services offices. Any change you report may affect your eligibility for medical benefits. The Medical Assistance Program pays for your health care costs when no third party resource is responsible to pay for them, or when the third party resource will not pay enough of your medical bills. HFS Health Benefits HotlineMonday - Friday (except state holidays)8 a.m. - 5 p.m.1-800-226-0768Persons using a TTY can call 1-887-204-1012. Transfers the payment to another applicable claim and corrects the accounts receivable file, if no refund is due. If information does not apply, enter N/A. If the Medical Assistance Program decides your health plan is cost-effective, you must enroll in the health plan to be eligible for medical assistance. WebIDHS: Illinois Department of Human Services. The mission of the Office of the Inspector General is to prevent, detect and eliminate fraud, waste, abuse, misconduct and mismanagement in the programs administered by the Departments of Healthcare and Family Services and Human Services. If possible, you should not pay your medical bills until you learn whether you qualify for medical benefits. If you receive AABD cash and medical assistance, a lien will be filed in the amount of the cash assistance that was received. The State of Illinois has the legal right to recover assistance received through the Aid to the Aged, Blind or Disabled (AABD) program. The following organization chart represents basic structure and the departments senior management. Box 19174Springfield, Illinois 62794-9174Attn: Personal Injury Unit. HFS offers many different healthcare programs for the people of Illinois. The success of collections depends in part on the age of the overpayment. All payments are handled by IDHS Bureau of Collections. Other money you get, like money from Social Security or a pension, is unearned income. A claim may not be filed against your estate if recovery would cause an heir or beneficiary undue hardship. Toll-free 1-800-843-6154 or (TTY) 1 WebState of Illinois Department of Human Services Bureau of Collections P.O. A claim can be filed against your estate. If you apply because you have a disability, you will be told within 60 days. Yes. You will receive a notice telling you if you qualify to enroll in the Pay-in Spenddown option. Send the original Overpayment Referral packet to: Keep a copy of the overpayment packet for the client file. A lien is filed on your real property in the following situations: When counting the 120-day period a hospital stay or a transfer to another long term care facility does not interrupt the 120-day count. Hr HFS or DHS will let you know if you qualify within 45 days of the date you apply. A caseworker at the local office will answer your questions. (FCRC) If an FCRC finds that the overpayment amount has changed, send Change of Overpayment Information (Form 2404C) to the Bureau of Collections, A client error includes, but is not limited to, an error that occurs when: The client fails to report or falsely reports income or household composition that affects the amount of the parent copayment. It looks like your browser does not have JavaScript enabled. If you are found guilty of this crime, you may have to pay a fine, go to prison, or both. To apply for medical benefits in person, go to your local DHS Family Community Resource Center (FCRC). For additional information about the various types of payment recoveries, please write to: Illinois Department of Healthcare and Family ServicesBureau of Collections - Technical Recovery SectionP.O. You can only ask to have your bill reviewed if you have been contacted by a collection agency or threatened with a lawsuit about payment of the bill. Fraud is a serious crime. Liens are not filed on mobile homes. Liens are filed on both homestead and non-homestead property. If you are age 65 or older, are blind or have a disability, your assets will also be reviewed. If you help others withhold information or make untrue statements about their family income or assets, you also may be guilty of fraud. DHS will accept your application as long as it has your name, address and signature. &C6 Box 19174Springfield, Illinois 62794-9174. (FCRC) Fax Form 3660 to the EBT Unit at (217) 524-3124 or email to DHS .LINK@illinois.gov. (FCRC) Make a copy of the form. A lien will not be filed against your real property when you reside in a long term care facility if your property is occupied by your spouse, your child under age 21, your child over age 21 who is blind or disabled or, in some cases your brother or sister. An estate claim is filed for clients who were receiving assistance at the time of death and clients who were cancelled prior to death. The call is free. Tomorrow: 8:00 am - 5:00 pm. Secretary of Transportation Office of Planning and Programming Office of Highways Project Implementation Office of Intermodal Project Implementation Office of Communications Office of Legislative Affairs Today: 8:00 am - 5:00 pm. WebCollections: 217-782-1348 Comprehensive Health Services: 217-785-2867 Drug Prior Approval for Providers 1-800-252-8942 Health Benefits Hotline 1-800-226-0768 Health Persons using a teletypewriter (TTY) can call 1-877-204-1012. <>/ProcSet[/PDF/Text]>>/Subtype/Form>>stream The departments mission is to improve the health status of the individuals enrolled in its programs, while simultaneously containing costs and maintaining program integrity. CLOSED NOW. Call your local DHS Family Community Resource Center or you can call: DHS Bureau of Customer Inquiry & AssistanceMonday - Friday (except state holidays)8:30 a.m. - 5 p.m.1-800-843-6154 Persons using a TTY can call 1-800-447-6404. parent changes providers with proper notification and the original provider bills for days beyond the last day of care); The provider receives duplicate payments for services provided; The provider does not comply with program policies (i.e. For more information on liens and claims, get the brochure called Property Liens and Estate Claims from your local DHS Family Community Resource Center, or you may download or print the brochure. The call is free. The client fails to timely report a change in income, hours of employment or school, household composition or provider arrangements and the change would have resulted in a lesser benefit received. 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