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Form HFS1313 Medical Food Nutrition Review Questionnaire - Illinois
What Is Form HFS1313?
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 Form HFS1313?
A: Form HFS1313 is the Medical Food Nutrition Review Questionnaire for Illinois.
Q: Who needs to fill out Form HFS1313?
A: Form HFS1313 needs to be filled out by individuals seeking medical food nutrition support in Illinois.
Q: What is the purpose of Form HFS1313?
A: The purpose of Form HFS1313 is to assess the medical necessity of prescribed medical food nutrition therapy.
Q: What information is required on Form HFS1313?
A: Form HFS1313 requires information such as the patient's personal details, diagnosis, prescribed medical food, and healthcare provider information.
Q: Are there any submission deadlines for Form HFS1313?
A: Yes, Form HFS1313 should be submitted within 90 days of the prescription date or 30 days before the prior authorization period expires, whichever is earlier.
Q: Who can I contact for further assistance with Form HFS1313?
A: For further assistance with Form HFS1313, individuals can contact the Illinois Department of Healthcare and Family Services or their healthcare provider.
Form Details:
- Released on March 1, 2021;
- 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 HFS1313 by clicking the link below or browse more documents and templates provided by the Illinois Department of Healthcare and Family Services.
