Billing & Insurance

...an application, please click below: Required Documents (English) Required Documents (Spanish) Required Documents (Polish) Frequently Requested Forms Room and Board Financial Assistance Statement (English) Room and Board Financial Assistance Statement (Spanish) Room and Board Financial Assistance Statement (Polish) Paid in Cash (English) Paid in Cash (Spanish) Paid in Cash (Polish) Self-Attestation Letter of Insurance (English) Self-Attestation Letter of Insurance (Spanish)...

Patient Rights & Responsibilities

...800-537-7697 (TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html English: ATTENTION: If you speak ENGLISH, language assistance services, free of charge, are available to you. Call (312) 864-0185. Spanish: ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (312) 864-0185. Polish: UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer...

Governance

...please complete the form below. Register to receive Board and Committee Agendas by Email Name* First Last Phone* Phone Type* HomeMobileWork Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Title* Company Name* Email*...

Palak Shah

Languages spoken: English, Hindi, Gujarati

Medicaid Redetermination Information

...envelope to: Central Scanning Office P.O. Box 19138 Springfield, IL 62763 Or Fax: 844-736-3563 Drop off your completed paperwork at a DHS Family Community Resource Center Redetermination Resources FAQs for Medicaid Members English Español Polski 中文 हिंदी العربية Русский FAQs for FQHCs/Providers English Español Polski 中文 हिंदी العربية Русский Redetermination Flyers English Español Polski 中文 हिंदी العربية Русский Social Assets...

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