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Form HFS3461 Long Term Care Facility Third Party Liability (Tpl) Payment Transmittal - Illinois
What Is Form HFS3461?
This is a legal form that was released by the Illinois Department of Healthcare and Family Services - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is HFS3461 Long Term Care Facility Third Party Liability (TPL) Payment Transmittal?
A: HFS3461 Long Term Care Facility Third Party Liability (TPL) Payment Transmittal is a form used in Illinois for transmitting TPL payments for long term care facilities.
Q: Who uses the HFS3461 form?
A: Long term care facilities in Illinois use the HFS3461 form to transmit TPL payments.
Q: What is Third Party Liability (TPL)?
A: Third Party Liability (TPL) refers to a situation where someone other than the patient is financially responsible for the patient's medical expenses.
Q: What information is required on the HFS3461 form?
A: The HFS3461 form requires information such as the facility name, facility ID, patient name, TPL source, and TPL payment details.
Q: What is the purpose of transmitting TPL payments using the HFS3461 form?
A: The purpose of transmitting TPL payments using the HFS3461 form is to ensure proper reimbursement for medical services provided by long term care facilities.
Form Details:
- Released on July 1, 2009;
- The latest edition provided by the Illinois Department of Healthcare and Family Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form HFS3461 by clicking the link below or browse more documents and templates provided by the Illinois Department of Healthcare and Family Services.
