This is a legal form that was released by the Illinois Department of Healthcare and Family Services - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is the purpose of Form HFS1433?
A: Form HFS1433 is used to establish a Long Term Care Provider Agreement for State-Operated Facilities in Illinois.
Q: What is a Long Term Care Provider Agreement?
A: A Long Term Care Provider Agreement is a contract between a provider and the state that outlines the terms and conditions for providing long-term care services.
Q: What is a State-Operated Facility?
A: A State-Operated Facility is a long-term care facility that is owned and operated by the state of Illinois.
Q: What is Provider Type 34?
A: Provider Type 34 refers to state-operated long-term care facilities in Illinois.
Q: Who is eligible to use Form HFS1433?
A: State-operated long-term care facilities in Illinois that fall under Provider Type 34 are eligible to use Form HFS1433.
Q: What information is required on Form HFS1433?
A: Form HFS1433 requires information such as facility name, address, provider number, and details of the services to be provided.
Q: Are there any fees associated with Form HFS1433?
A: There are no fees associated with completing and submitting Form HFS1433.
Q: How should completed Form HFS1433 be submitted?
A: Completed Form HFS1433 should be submitted to the Illinois Department of Healthcare and Family Services (HFS) by mail or electronically.
Q: Are there any deadlines for submitting Form HFS1433?
A: Specific deadlines for submitting Form HFS1433 may be outlined by the Illinois Department of Healthcare and Family Services (HFS) and should be followed accordingly.
Form Details:
Download a fillable version of Form HFS1433 by clicking the link below or browse more documents and templates provided by the Illinois Department of Healthcare and Family Services.