Sometimes, you may find that you are being billed for medical treatment or some other service or item that you think should have been covered by Medicaid. Perhaps the bill has been placed with a collection agency or you are being sued or threatened with a lawsuit. In these cases, you may file a Medicaid Claim Inquiry with DHS.
Fill out the form completely. Then, attach a copy of the collection agency's letter or written evidence of a pending or threatened lawsuit. Then, send the form to:
Illinois Department of Healthcare and Family Services
Bureau of Comprehensive Health Services
201 South Grand Avenue East
Springfield, Illinois 62763-0002
You also can call the litigation collection staff at (217) 782-5565.
After they receive the form, HFS will look into it and send you a written response within 30 days. They may agree to pay the bill at this time. If they decide that the bill is not covered by Medicaid, you can file an appeal.
If HFS decides that the bill would have been covered, but that the medical provider didn’t bill HFS properly, you could win your appeal.