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  • Medicaid Provider Alert: Provider revalidation has begun and those not completing the process risk disenrollment.  Check your account now to learn when your revalidation is due. More information here.
Elizabeth M. Whitehorn, Director

Provider Notice issued 04/07/10

Forms Available on Healthcare and Family Services Web site

To:​ Providers of Long Term Care​
Date:​ April 7, 2010​
Re:​ Forms Available on Healthcare and Family Services Web site​

This notice is to inform all long term care providers that commonly used forms are available on the department’s Web site. 

Forms used to report an admission, discharge, change in level of care, bed reserve/temporary absence, and income from private insurance are all formatted to be easily printed. To ensure the newest version of a form is being used, check the Web site since the latest version will be the version posted.

Forms commonly used by long term care facilities that are available online include:

Please check the department’s Web site to view all of the forms available on-line at: http://www.hfs.illinois.gov/medicalforms/

If you have any questions concerning this notice, contact the Bureau of Long Term Care at 217-524-7245.

Theresa A. Eagleson, Administrator

Division of Medical Programs