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. 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. For children under age 16, school or day care records or a report card. Fraud is a serious crime. Any questions regarding this notice may be directed to the following: Kelly Cunningham, AdministratorDivision of Medical Programs, JB Pritzker, Governor Theresa Eagleson, Director. DHS will accept your application as long as it has your name, address and signature. For more information, call the All Kids Hotline at 1-866-ALL-KIDS (1-866-255-5437). If you are found guilty of this crime, you may have to pay a fine, go to prison, or both. If you have any questions or need more information, call the DHS Helpline at 1 Be sure to read the form carefully and follow the instructions on the form. You must also tell us if you have any other health insurance. H,N07GFbCd>~2VU!g|A+ 3rN9=%s&?FG'SIq jQGZ.6,E{ & If you received AABD medical assistance only, a claim will be filed for the amount of medical assistance paid after your 55th birthday. 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. 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. 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 Complete the Child Care Overpayment Referral (. WebIDHS: Illinois Department of Human Services. You may have the option of paying your spenddown amount directly to HFS. Persons using a teletypewriter (TTY) can call 1-800-447-6404. 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. 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. 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). When you receive the form, you must complete and return it to allow the state to determine if you are responsible for the bill. Assets are the things you own, like money in a bank account or life insurance. endstream The CCR&R/Site provider and Bureau of Collection will receive a copy of the letter. endstream Wishing you and your families a peaceful and prosperous holiday season. Transfers the payment to another applicable claim and corrects the accounts receivable file, if no refund is due. The Inspector General is appointed by and reports to the Governor and is confirmed by the Senate. HFS and DHS will ask most U.S. citizens who want medical benefits to provide one of the following documents: U.S. Passport, Certificate of Naturalization (N-550 or N-570) or Certificate of Citizenship (N-560 or N-561). Where the overpayment period is over 15 months old and the information is not available in the case record. It looks like your browser does not have JavaScript enabled. the provider charges the subsidized parent more than they charge private pay parents.). A lien will be filed against both homestead and non-homestead real property, regardless of the property's market value. 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. WebThe Illinois Department of Transportation (IDOT) is committed to eliminating and remedying unlawful discrimination in employment and in the delivery of services, through the development of policies and programs regarding civil rights in A caseworker at the local office will answer the questions you have. endobj Please turn on JavaScript and try again. You can also apply online for some programs. <>/ProcSet[/PDF/Text]>>/Subtype/Form>>stream 2 0 obj Two state agencies work together to help Illinoisans get HFS Medical Program benefits. The Department of Healthcare and Family Services administers health insurance programs for children, pregnant women, and adults who are residents of Illinois. Box 19174Springfield, Illinois 62794-9174. Please turn on JavaScript and try again. A third party may be another person, an insurance company, an organization or a program. Your children who qualify for medical benefits will continue to receive them whether or not you cooperate. Works with the Bureau of Investigations, the Illinois State Police, and the Attorney General. Grace B. Hou, Secretary, IDHS Help Line 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. If your application is approved, your medical benefits usually begin with the month you apply. 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. 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 (DHS) office. Be sure to give your complete name and address. Upload the original to the client's electronic case file in IES. If you do not get these benefits, then your age, blindness or disability will be reviewed when 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. Be specific and concise, but do not use abbreviations. 9 0 obj Please show us the original version of your documents. WebThe Illinois Department of Human Services (IDHS) is one of Illinois' largest agencies, with more than 13,000 employees. Copies of the letter will be sent to: IDHS Bureau of Collections. It looks like your browser does not have JavaScript enabled. Box 19174Springfield, Illinois 62794-9174Attn: Personal Injury Unit. endobj 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. Depending on your income and situation you may also have to cooperate with Child Support Enforcement (CSE) activities. Call or visit your local DHS office. Pregnant women and families can also apply for medical benefits at certain medical facilities and clinics, online atthe All Kids Web site, or through the mail. If you withhold information or do not tell us the truth about your family income or assets, you may be guilty of fraud. 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. Persons using a teletypewriter (TTY) can call 1-800-447-6404. WebCollection Agency Registration Collection Agency Branch Office Registration Personal/Employment History Collection Agency Financial Statement Collection Please turn on JavaScript and try again. If you cannot keep an appointment, be sure to tell your caseworker right away. 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. Box 19502 Springfield, Illinois 62794-9502 If you cannot pay the full amount, you must make If your third party coverage changes or if family members are added to or deleted from the coverage, you must tell your caseworker within five days. This amount is called your spenddown amount. Grace B. Hou, Secretary, IDHS Help Line If you participate in the Spenddown Program, payment may be made for some of your medical care each month if you have medical bills that equal a certain amount. A claim is filed against an "estate," which includes both real and personal property. WebPART 165 COLLECTIONS AND RECOVERIES The General Assembly's Illinois Administrative Code database includes only those rulemakings that have been 1-800-843-6154 Springfield, IL United States. A claim will be filed against your estate in the following situations: If you received AABD cash and medical assistance, a claim will be filed to recover all cash assistance you received and any medical assistance paid after you reached age 55. All payments are handled by IDHS Bureau of Collections. You can also fill it out, sign it, and leave it at the FCRC. If you help others withhold information or make untrue statements about their family income or assets, you also may be guilty of fraud. WebEnsures all collection documents and forms are completed, timely, and processed through the Automated Case Management System (ACM), when needed. 2P t.C4PH2P,H(+*P ,MtLBr4R34C\C 4 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. Also, call this telephone number if you know someone who is withholding information or not telling the truth about the medical services they need or if you know someone who is charging the HFS Medical Programs for medical care that he or she did not give. If you have any questions or need more information, call the DHS Helpline at 1-800-843-6154, Monday through Friday (except state holidays), between 8:30 a.m. and 5 p.m. The cause of each overpayment shall be classified as administrative error, client error, or provider error. To apply for medical benefits in person, go to your local DHS Family Community Resource Center (FCRC). r "9)1BR` w Or you may call 1-800-435-0774 (TTY: 1-877-734-7429). You can file an appeal by writing to the Bureau of Administrative Hearings, 401 South Clinton Street, Chicago, IL 60607. 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. If your caseworker cannot find you, your medical benefits will stop. Complete all blanks. Within the first five years that an overpayment is identified, the department recovers a You can get medical benefits even if you do not have an address, but you must tell your caseworker an address where you can pick up your medical card. . Hr 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. 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. HlSM0G? Other suggestions are listed on page 2 of the Overpayment Referral form. endstream 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. 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. Hw,JMTpuV*w5Pp In certain situations, liens on real property and claims against estates are used to do this. WebIllinois Department of Human Services, Bureau of Recruitment and Selection List of Employees There's an exhaustive list of past and present employees! 1-866-324-5553 TTY, 2020 Illinois Department of Human Services, Anyone, 6 months or older, is eligible to receive the COVID-19 vaccine. <>/ProcSet[/PDF/Text]>>/Subtype/Form>>stream Ensures all collection documents and forms are completed, timely, and processed through the Automated Case Management System (ACM), when needed. Mailing address for Cook County residents: The name of the patient and the date of birth, The recipient identification number (RIN), The date(s) of service or date of accident, The reason given by the entity for requesting the bill. Press Release 5 0 obj You will receive a medical card in the mail that you can use for your medical expenses. It looks like your browser does not have JavaScript enabled. Happy Holidays from Secretary Grace Hou and IDHS! Persons using a teletypewriter (TTY) can call toll-free at 1-800-447-6404. A claim may not be filed against your estate if recovery would cause an heir or beneficiary undue hardship. If information does not apply, enter N/A. Phone (800) 843-6154 . For example, if you get a health insurance payment for a bill HFS has paid, you must report it to your caseworker. You must tell DHS about medical benefits you receive or should receive. *JAgN] R8 We offer a range of services to help you become healthy and self The Pre-Payment Detail Inquiry Screen and the Payment Inquiry (PF-11) screen prints for each overpayment month are mandatory. Modified date: December 23, 2019. If the case does not meet the overpayment criteria, BCCD will deny the referral and notify the referring agency. If the debtor submits written documentation to eliminate the debt, BCCD will issue a letter to rescind the overpayment. 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