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Illinois Life and Health Insurance Guaranty Association Relating to Penn Treaty, in Liquidation PO Box 4198 Lisle, IL 60532 Phone (773) 4444071 Fax (773) 3043559 Inquiry×Illinois.org (secure method

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How to fill out home health care claim

01

Step 1: Obtain the claim form from your home health care provider.

02

Step 2: Fill in your personal information, including your name, address, and contact information.

03

Step 3: Provide your insurance information, including your policy number and group number.

04

Step 4: Indicate the date of service for the home health care.

05

Step 5: Describe the reason for the home health care and provide any relevant medical diagnosis codes.

06

Step 6: Include itemized details of the services provided, such as the type of care, duration, and costs.

07

Step 7: Attach any supporting documents, such as medical records, prescriptions, or invoices.

08

Step 8: Review the completed form for accuracy and completeness.

09

Step 9: Submit the claim form to your insurance provider either by mail or online.

10

Step 10: Keep a copy of the completed form and any supporting documents for your records.

Who needs home health care claim?

01

Anyone who has received home health care services and wants to seek reimbursement from their insurance provider needs a home health care claim.

02

This includes individuals who have undergone medical procedures or treatments at home, received nursing care, physical therapy, or other similar services.

03

The claim is necessary to obtain financial coverage for the costs incurred during the home health care services.

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