Sometimes, you may find that you are being billed for medical treatment or some other service or item that you think should have been covered by Medicaid. Perhaps the bill has been placed with a collection agency or you are being sued or threatened with a lawsuit. In these cases, you may file a Medicaid Claim Inquiry with DHS.

Fill out the form completely.  Then, attach a copy of the collection agency's letter or written evidence of a pending or threatened lawsuit. Also attach a copy of the medical bill(s). Then, send the form to:

Healthcare and Family Services
Bureau of Hospital and Provider Services
607 East Adams Street, 11th Floor
Springfield, Illinois 62701-2034

Attn: Payment Support / Collins vs. Bradley 

Contact Litigation/Collection at (217) 558-1577.

You also can call the litigation collection staff at (217) 782-5565.

After they receive the form, HFS will look into it and send you a written response within 30 days. They may agree to pay the bill at this time. If they decide that the bill is not covered by Medicaid, you can file an appeal. 

If HFS decides that the bill would have been covered, but that the medical provider didn’t bill HFS properly, you could win your appeal.

If the bill is under a year old, has not gone to collections, and there is no litigation involved, contact HFS's Health Benefit Hotline. Their phone number is 1-800-226-0768. They can talk to the parties involved and try to help you resolve the bill.

HFS's Health Benefit Hotline can also provide more information about the Medicaid Claim Inquiry. 

Please note that if Medicaid denies a service, an appeal would need to be made directly with your Medicaid plan.