Form HFS1433 Long Term Care Provider Agreement State-Operated Facility (Provider Type 34) - Illinois

Form HFS1433 Long Term Care Provider Agreement State-Operated Facility (Provider Type 34) - Illinois

What Is Form HFS1433?

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.

FAQ

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.

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Form Details:

  • Released on May 1, 2013;
  • The latest edition provided by the Illinois Department of Healthcare and Family Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

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.

Download Form HFS1433 Long Term Care Provider Agreement State-Operated Facility (Provider Type 34) - Illinois

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