8 0 obj At the hearing, you may represent yourself or be represented by a lawyer, relative or friend. If you are homeless, tell your caseworker how to reach you. When your caseworker is done, he or she will give you a computer printout with your answers on it and ask you to sign it. WebIllinois State-Human Service Department. Box 19502 Springfield, Illinois 62794-9502 If you cannot pay the full amount, you must make It looks like your browser does not have JavaScript enabled. Grace B. Hou, Secretary, IDHS Help Line \R*kS"JU.WKXk2t,=%iEZ3EYongfYvu9R> `KEM/(+$9|qeT_hON9Wj2R+N6;f DHS or HFS reviews your case at least once a year to see if you still qualify for medical benefits. Sometimes medical assistance pays a medical bill that a third party resource should have paid. If you have a good reason for not giving us this information, tell your caseworker. HFS or DHS will let you know if you qualify within 45 days of the date you apply. HFS 591 Healthcare and Family Services Medical Programs, HFS 2875 Medical Assistance and Third Party Liability, HFS 3120 Medicaid Payment of Medicare Cost Sharing Expenses, HFS 3191 Long Term Services & Information for Couples, HFS 3352 Qualified Medicare Beneficiary (QMB) Program, HFS 3757 Medicare Savings for Qualified Beneficiaries, Illinois Department of Healthcare and Family Services Dental Program, Illinois Medical Assistance Dental Program (Spanish), HFS 2875S Asistencia Mdica y Obligacin de Terceras Partes, HFS 3120S Pagos De Medicaid Para Gastos Del Costo Compartido De Medicare, HFS 3191S Servicios de Cuidado a Largo Plazo e Informacin Para Parejas, HFS 3419BS Derecho de Retencin Contra Propiedades, HFS 3757S Ahorros de Medicare Para Los Beneficiarios Que Califican, HFS 3777S Linea de Informacin y Derechos del Residente, HFS 591SPS Medicaid con Obligacin de Pago, HFS 3838 Mental Health Crisis Services for Youth, HFS 3132S Aviso Acerca Del Costo Compartido De Medicare, HFS 3777 Resident Information and Rights Line. If the debtor submits written documentation to reduce the debt, BCCD will issue a new letter indicating the new balance. Canceled for receipt of earned income and receipt of past unreported earnings is known or suspected and the employer has been contacted by the Family Community Resource Center, but the employer does not initially cooperate. Assets are the things you own, like money in a bank account or life insurance. Wishing you and your families a peaceful and prosperous holiday season. Press Release JB Pritzker, Governor Theresa Eagleson, Director. Tell your caseworker if you have a good reason. llinois Department of Healthcare and Family Services, Bureau of Collections - Technical Recovery Section, HFS 2875 Medical Assistance and Third Party Liability, HFS 3120 Medicaid Payment of Medicare Cost Sharing Expenses, HFS 3191 Long Term Services & Information for Couples, HFS 3352 Qualified Medicare Beneficiary (QMB) Program, HFS 3757 Medicare Savings for Qualified Beneficiaries, HFS 591 Healthcare and Family Services Medical Programs, Illinois Department of Healthcare and Family Services Dental Program, Illinois Medical Assistance Dental Program (Spanish), HFS 2875S Asistencia Mdica y Obligacin de Terceras Partes, HFS 3120S Pagos De Medicaid Para Gastos Del Costo Compartido De Medicare, HFS 3191S Servicios de Cuidado a Largo Plazo e Informacin Para Parejas, HFS 3419BS Derecho de Retencin Contra Propiedades, HFS 3757S Ahorros de Medicare Para Los Beneficiarios Que Califican, HFS 3777S Linea de Informacin y Derechos del Residente, HFS 591SPS Medicaid con Obligacin de Pago, HFS 3838 Mental Health Crisis Services for Youth, HFS 3132S Aviso Acerca Del Costo Compartido De Medicare, HFS 3777 Resident Information and Rights Line, local Department of Human Services office. The TPL code lets your doctor, hospital or clinic know that there is a third party that may be responsible to pay for all or part of your medical care. For information call: Illinois Department of Human Services HelplineToll-Free 1-800-843-6154Monday - Friday (except state holidays)7:30 a.m. - 7 p.m. An administrative error includes, but is not limited to, an error caused by: Incorrect application of any Federal or State regulation, policy or procedure; Fraud committed by an individual who works for the CCAP program. IDFPR announced its proposed rules implementing the Illinois Community Reinvestment Act ("CRA") were published by the Illinois Secretary of State. Our vision is that all Pennsylvanians live safe, healthy, and independent lives, free of discrimination and inequity. 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. 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. They will send you a form. Box 19174Springfield, Illinois 62794-9174. HFS offers many different healthcare programs for the people of Illinois. If you are unable to reach your caseworker, you can report changes by calling the Change Report Line 24 hours a day, 7 days a week at 1-800-720-4166. All your earned income and unearned income is reviewed when you apply for medical benefits. WebThe Illinois Department of Human Services ( IDHS) is the department [1] [2] of the Illinois state government responsible for providing a wide variety of safety net services to Illinois residents in poverty, who are facing other economic challenges, or who have any of a variety of disabilities. Ensures all collection documents and forms are completed, timely, and processed through the Automated Case Management System (ACM), when needed. You will be asked to turn the payment over, or if the payment is more than what HFS paid for you, you will have to repay the amount HFS paid. This is often done by mail using a Redetermination or Renewal form. It looks like your browser does not have JavaScript enabled. If you are receiving or are approved to receive Supplemental Security Income (SSI), Social Security Disability or Railroad Disability benefits, you do not have to give us documents to prove you are aged or blind or have a disability. , Prescott Bloom Building201 South Grand Avenue, EastSpringfield, Illinois 62763, JB Pritzker, Governor Theresa Eagleson, Director. 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. HFS has the legal right to recover the amount it paid for medical care for some persons who are aged, blind or have a disability. 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. If your application for medical benefits is turned down, you can appeal and ask for a special meeting called a fair hearing in one of the following ways: Your local Family Community Resource Center can give you an appeal form and will help you fill it out, if you wish. In fiscal year 2015, more than $1.4 billion was collected in support owed to Illinois children. A lien is filed on "real property," which is land and anything erected on, growing on, or affixed to the land, such as buildings. If the debtor submits written documentation to eliminate the debt, BCCD will issue a letter to rescind the overpayment. 5 0 obj 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. Supervisors should review and approve each overpayment referral. Please turn on JavaScript and try again. Either way, the Court may order a halt to this collection, and, repayment. Supervisors must sign and date the referral on page 2. A third party may be another person, an insurance company, an organization or a program. Box 19174 Springfield, Illinois 62794-9174 For information about For information about Department of Human Services (DHS) programs: Call or visit your local Department of Human Services office. This is your application. A claim can be filed against your estate. 9 0 obj To find out if medical assistance paid a medical bill for which you received a payment from another source, ask your medical care provider. If you need help to find a provider, call Illinois Health Connect at 1-877-912-1999. Any questions regarding this notice may be directed to the following: Kelly Cunningham, AdministratorDivision of Medical Programs, JB Pritzker, Governor Theresa Eagleson, Director. You should also tell the provider billing you that you are covered by HFS medical benefits. r "9)1BR` w Persons using a teletypewriter (TTY) can call 1-877-204-1012. Hr <>stream Where the overpayment period is over 15 months old and the information is not available in the case record. An estate claim is filed for clients who were receiving assistance at the time of death and clients who were cancelled prior to death. Hr Upload the original to the client's electronic case file in IES. Be the first to review! Illinois Department of Healthcare and Family Services Bureau of Collections, Technical Recovery Section 401 S. Clinton - 5th Floor Chicago, Illinois *JAgN] R8 If you receive poor medical care, have problems getting medical care or are charged for medical services that are covered by HFS Medical Programs, call: 1-844-453-7283 Persons using a TTY can call 1-800-447-6404. <>/ProcSet[/PDF/Text]>>/Subtype/Form>>stream You must see doctors who are network providers for your third party resource. Persons who receive medical assistance only and who have resided in a medical institution for at least 120 calendar days will be notified of the decision to file a lien on their real property. 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. If the case does not meet the overpayment criteria, BCCD will deny the referral and notify the referring agency. endobj endstream He also reviewed DHSs Bureau of Collections (the BOC) recipient ledger inquiry from August 2, 2019. endobj It looks like your browser does not have JavaScript enabled. The call is free. If you have too much income or assets to qualify for medical benefits, but you meet all other requirements, you may qualify for the medical benefits Spenddown Program. Please turn on JavaScript and try again. 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 want to appeal the decision, you can write a letter requesting a hearing or fill out a Notice of Appeal form. For Lien and Estate cases in Cook County, please send email inquiries and referrals to: For Lien and Estates cases in all other jurisdictions, please send email inquiries and referrals to: For Personal Injury and Casualty cases in Cook County, please send email inquiries and referrals to: For Personal Injury and Casualty cases in all other jurisdictions, please send email inquiries and referrals to: For Workers' Compensation cases in Cook County, please send email inquiries and referrals to: For Workers' Compensation cases in all other jurisdictions, please send email inquiries and referrals to: For additional information about a waiver of estate recovery email us at the links above or write to: Illinois Department of Healthcare and Family Services Bureau of Collections - Technical Recovery SectionP.O. R5%CwG 4E`\'$gF1IM4l3zqn]i 0'\8b Q2>oK-OKkZ&]+Ul;.c Q&mc[9 NowuLfj>-L~}b1g&vX(}FwN'` ` If you have any questions or need more information, call the DHS Helpline at 1 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. Earned income is wages from your job or profits from your business. For example, if you get a health insurance payment for a bill HFS has paid, you must report it to your caseworker. Medical Programs and If you cannot keep an appointment, be sure to tell your caseworker right away. JB Pritzker, Governor Theresa Eagleson, Director. We will contact the U.S. Bureau of Citizenship and Immigration Services to check their status. 1-800-843-6154 If you do not know where your local office is or you are unable to go to there, call: Illinois Department of Human ServicesBureau of Customer Inquiry & AssistanceMonday Friday (except state holidays) 7:30 a.m. - 7 p.m.Toll-free1-800-843-6154 or (TTY) 1-800-447-6404. Be sure to read the form carefully and follow the instructions on the form. Persons using a teletypewriter (TTY) can call toll-free at 1-800-447-6404. WebIDHS: Illinois Department of Human Services. Please show us the original version of your documents. If the case meets the criteria for overpayment, BCCD will issue the Overpayment letter. DHS can help with this. the provider charges the subsidized parent more than they charge private pay parents.). Other suggestions are listed on page 2 of the Overpayment Referral form. The agency is organized into two major divisions, WebChicago, Illinois 60604 312-596-7230 FOR THE REMAINDER OF ILLINOIS United States Department of Labor Wage and Hour Division 3161 W. White Oaks, Dr., Suite 203 Springfield, IL 62704 217-793-5028 Occupational Safety & Health Act (#OSHA 3165) poster is available by contacting the agency at: OSHA Publications 230 South Dearborn, Room endstream To: Enrolled Hospitals: Chief Executive Officers: Chief Financial Officers: and Patient Accounts Managers, Re: Third Party Requests for Medicaid Patient Bills and Medical Records, _____________________________________________________________________________. Complete all blanks. A lien will be filed against both homestead and non-homestead real property, regardless of the property's market value. Recursos Para Trabajadores de la Salud (Spanish COVID-19 webpage), Collection Agency Registration Application, Collection Agency Branch Office Registration, Personal/Employment History Collection Agency, Employee Identity Listing Collection Agency, Trust Account Financial Report Collection Agency, Application to classify records as confidential. Adults do not qualify if they refuse to cooperate with CSE unless they have a good reason for not cooperating. When this happens, medical assistance has the right, by law, to collect its payment from the third party. 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 The Bureau of Collections makes all repayment arrangements, including negotiating all installment repayment plans for canceled SNAP cases. @~b0E,el8[R$;inx8R+pSxwChE?7. 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. If you are discharged from the long term care facility to the community and then return to a medical institution, the 120-day count starts over with the first day of re-admission. The Inspector General is appointed by and reports to the Governor and is confirmed by the Senate. This is called Pay-in Spenddown. WebCollection. HlSM0G? 2P t.C4PH2P,H(+*P t,,Br5\4u LM5\+SRRK3SS~1f!^\!\ !4 DHS will accept your application as long as it has your name, address and signature. A caseworker at the local office will answer the questions you have. Fax number for Cook residents: 312-338-0304, Fax number for all other counties: 217-524-5672, Telephone number for Cook County residents: 312-793-3528 and 312-793-3529, Telephone number for all other counties: 217-785-8711. You can also apply online for some programs. If you can get free health insurance coverage (for you or you and your child who receives medical assistance) through your job, union or other organization, youmust apply for it. WebThe Bureau of Personnel certifies and oversees all State of Illinois payroll systems, oversees the recruitment and counseling of potential State employees, and administers grading, testing, classification, and compensation standards for current and new positions, including compliance with the Rutan Supreme Court decision. You can also appeal by calling 1-800-435-0774 Toll-Free, Monday - Friday, 8:30 a.m. to 4:45 p.m. (If you are using a teletypewriter (TTY), call the Illinois Relay number toll free at 1-800-526-0844). Your children who qualify for medical benefits will continue to receive them whether or not you cooperate. Child Support Services. Alcoholism Information & Treatment Centers. 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. You may have the option of paying your spenddown amount directly to HFS. A person who has resided in a medical institution for at least 120 calendar days is not reasonably expected to return home. To qualify for federal child-support services funds, each state must have a centralized unit to receive and distribute child-support payments made through income withholding, even if a family has not enrolled in the full child-support services program. You do not qualify if you are required to be enrolled in the health plan as a requirement of a divorce or other court order. 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