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Handbook for Chiropractic Services Chapter B-200 Appendices APPENDIX B-1 TECHNICAL GUIDELINES FOR PAPER CLAIM PREPARATION FORM HFS 1443, PROVIDER INVOICE Please follow these guidelines in the preparation.

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The appeal packet must be submitted to DDD within 60 calendar days of the date that the individual receives the Notice of Individual's Right to Appeal Medicaid Waiver Determinations [IL462-1202].

Call the DHS Customer Service Helpline for assistance at: (800) 843-6154 voice/(866) 324-5553 TTY, Monday through Friday, 8:00 a.m. to 5:30 p.m., except state holidays.

Medicare claims must be filed no later than 12 months (or 1 full calendar year) after the date when the services were provided.

If you aren't sure if your Medicaid coverage has been approved yet or if it is still active, you can check Manage My Case or call the state's Automated Voice Recognition System (AVRS) at 1-855-828-4995 with your Recipient Identification Number (RIN).

Timely filing is 180 days from the discharge date. Medicare/Medicaid combination claims are allowed 24 months from the date of service. If you have an exception to the 180 days filing limit, submit the claim on paper with an HFS 1624A override request form.

MEDICAID APPLICATION DOCUMENTS DRIVERS LICENSE, PHOTO ID CARD, OR PASSPORT. SOCIAL SECURITY CARD FOR APPLICANT (and spouse if living) RED, WHITE, AND BLUE MEDICARE CARD. HEALTH INSURANCE CARDS, PREMIUM AMOUNT STATEMENT.

Non-Institutional claims are subject to a timely filing deadline of 180 days from date of service. Timely filing applies to both initial and re-submitted claims.

This may include medical care/treatment/supplies, nursing home services, in-home personal care, Medicare premiums, and prescription drugs. Effective April 2023 – March 2024, the Medically Needy Income Limit (MNIL) in IL is $1,215 / month for an individual and $1,643 / month for a couple.

1-800-842-1461. To use the automated system, you must have the individual's Medicaid Recipient Identification Number (RIN) and the date of service for which you need eligibility information. If you do not know the individual's RIN, you need the individual's name, birthdate and SSN and must talk with hotline staff.

What do I do if my Medical Card is lost or stolen? Call DHS 1-800-843-6154 or HFS 1-800-226-0768 (TTY 1-877-204-1012) to request a replacement card.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232