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Hospital Statement of Cost BHF Page 1 Healthcare and Family Services, Bureau of Health Finance, 201 S. Grand Ave. E., Springfield, IL 62763 General Information PRELIMINARY Name of Hospital: Mercy
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What is name of hospital?
The name of the hospital is XYZ Hospital.
Who is required to file name of hospital?
The hospital administrator or designated representative is required to file the name of the hospital.
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To fill out the name of the hospital, the administrator needs to provide the official name as registered with the appropriate authorities.
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The information that must be reported on the name of the hospital includes the full legal name of the hospital.
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