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FOR BHF USELL1 2021STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONGER CARE FACILITIES (FISCAL YEAR 2021) I.DPH License ID Number:
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Gather all necessary financial and patient data for the reporting period.
02
Complete the Cost Report forms accurately and thoroughly.
03
Verify that all data is entered correctly and all necessary supporting documentation is included.
04
Submit the Cost Report to the appropriate Medicare Administrative Contractor (MAC) for review.

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