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Elizabeth M. Whitehorn, Director

Provider Notice issued 06/09/14

Fiscal Year 2015 Hospital Inpatient and Outpatient Assessment Programs Notice of Assessments

To:​ ​Illinois Hospital Providers
​Date: ​June 9, 2014
​Re: Fiscal Year 2015 Hospital Inpatient and Outpatient Assessment Programs Notice of Assessments​

This is to inform you that the department has determined that your facility is subject to the inpatient and outpatient assessments imposed on Illinois hospital inpatient and outpatient services under the provisions of305 ILCS 5/5-A.

Enclosed are your facility’s inpatient and outpatient assessment remittance notices for fiscal year 2015. Also enclosed are tax calculation worksheets detailing the bases for the inpatient and outpatient assessments. The remittance notice has the facility’s name and address, the tax identification number and personal identification number (PIN) assigned by the department, the total amount due, and the due date. 

Hospitals must remit the monthly assessments using the Illinois State Treasurer’s E-Pay Program. In order to use this service, your hospital will need an Internet connection, checking account information (bank routing number and account number), from which the payment will be made, and the hospital’s current remittance card. If your hospital is not familiar with the Illinois State Treasurer’s E-Pay Program, please contact the Bureau of Hospital and Provider Services at (217) 524-7110.

In addition, each hospital is responsible for ensuring debit authorizations can be initiated from designated accounts in the appropriate dollar amount. Following is the company identification number to be given to your banking institution, if debit block filters are used on the hospital’s account. Please use 1550895818 for these transactions.

If you have any questions concerning this information, please do not hesitate to contact the Bureau of Hospital and Provider Services by e-mail at hfs.bchs@illinois.gov, or by telephone at 217-524-7110.

 

Mashelle Rose, Acting Chief

Bureau of Hospital and Provider Services