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Health Financial Systems MEMORIAL HOSPITAL CARBONDALE In Lieu of Form CMS255210 This report is required by law (42 USC 1395g; 42 CFR 413.20(b)). Failure to report can result in all interim FORM APPROVED payments
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It is the official website for the Illinois Department of Healthcare and Family Services.
Individuals or families who are applying for or receiving medical assistance benefits from the state of Illinois.
You can fill out the forms online on the Illinois Department of Healthcare and Family Services website.
The purpose is to determine eligibility for medical assistance benefits and to ensure proper administration of healthcare programs.
Personal information, income, household size, medical expenses, and other related details.
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