Get Handbook Update - Bed Reserve - Hfs - Hfs Illinois

This guide provides clear, step-by-step instructions on how to effectively complete the Handbook Update - Bed Reserve - HFS - Hfs Illinois online. Users will find it easy to navigate through each section of the form with the assistance of the outlined processes.

Follow the steps to successfully complete your form.

1. Press the ‘Get Form’ button to access the Handbook Update - Bed Reserve - HFS - Hfs Illinois form and open it in your preferred editing tool.
2. Begin by entering your facility information. Input the 12-digit Facility I.D. Number, Facility Name, and Facility Address accurately as shown on your Provider Information Sheet.
3. For the recipient information, fill in the recipient's name (first and last) and their nine-digit Recipient I.D. Number as it appears on their current Medical Eligibility Card.
4. Next, complete the reserve bed information. Enter the bed type code, begin date, and end date for each bed reserve period on the same line. Use the following bed type codes: 11 for nonpayable hospital stay, 20 for payable therapeutic home visit, and 21 for nonpayable therapeutic home visit.
5. Ensure you format the begin and end dates correctly (MMDDYY). Use appropriate codes reflecting the recipient's status during their absence from the facility.
6. Once all sections are completed, the Facility Administrator or designated agent must sign and date the form to certify the accuracy of the information provided.
7. Finally, submit the original form to the Illinois Department of Public Aid at the provided address. Make sure to keep a copy for your records.

Complete your Handbook Update - Bed Reserve - HFS - Hfs Illinois form online today!