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FOR BHF USELL1
2017
STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT (COST REPORT)
FOR LONGER CARE FACILITIES
(FISCAL YEAR 2017)I.DPH License ID Number:
Facility
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How to fill out laboratory expense
01
Collect all necessary receipts and invoices for laboratory services.
02
Record the date of each expense.
03
List the name and contact information of the laboratory.
04
Specify the type of service or test performed.
05
Calculate the total cost of each expense.
06
Submit the filled out form along with the receipts to the appropriate department for reimbursement.
Who needs laboratory expense?
01
Individuals who have incurred laboratory expenses and are seeking reimbursement from their employer or insurance company.
02
Healthcare facilities that need to keep track of their laboratory expenses for billing and accounting purposes.
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What is laboratory expense?
Laboratory expense refers to the cost incurred for conducting tests, experiments, or research in a laboratory.
Who is required to file laboratory expense?
Individuals or businesses who have incurred laboratory expenses as part of their operations may be required to file laboratory expense.
How to fill out laboratory expense?
To fill out laboratory expense, one must detail the expenses incurred for laboratory tests, experiments, or research, including date, description, and amount.
What is the purpose of laboratory expense?
The purpose of reporting laboratory expense is to track and account for the costs associated with conducting tests, experiments, or research in a laboratory.
What information must be reported on laboratory expense?
The information to be reported on laboratory expense includes the date of the expense, description of the expense, and the amount spent.
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