Form Hfs 1517 – Fill Out and Use This PDF

Form Hfs 1517 is an important document for business operations. It has the necessary information needed to facilitate and structure specific processes in a corporate setting. By utilizing Form Hfs 1517, managers have the ability to monitor compliance, organization, and completing essential objectives effectively across all departments. With the use of this form, relevant stakeholders can stay up-to-date on timelines and milestones related to production and operation sites. Ultimately, it serves as a valuable tool during periodic reviews while giving confidence in terms of keeping track with performance metrics over time.

Form Hfs 1517 PDF Details

Form HFS 1517 is a tax form that is used to report the sale or exchange of property. This form must be filed by taxpayers who have realized a gain or loss on the sale or exchange of any property during the year. The form must be attached to the taxpayer's federal income tax return for the year in which the gain or loss was realized. The sale or exchange of property can result in a taxable gain or loss depending on the proceeds received from the transaction. Form HFS 1517 allows taxpayers to report these gains and losses to the Internal Revenue Service (IRS). The form must be completed correctly in order to ensure that all information is reported accurately. It is important to note that not all transactions will require you to file Form HFS 1517. If you have any questions about whether or not you need to file this form, please contact a qualified tax professional for assistance.

Question	Answer
Form Name	Form Hfs 1517
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	hfs1517 il478 form

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Illinois Department of Healthcare and Family Services

2946 Old Rochester Road

Springfield, Illinois 62703-5659

Online Forms Request: http://www.hfs.illinois.gov/forms/

Fax Number: (217) 557-3459

Please note that claims may be submitted through the department’s Medical Electronic Data Interchange, Internet Electronic Claims (MEDI/IEC) System at: http://www.myhfs.illinois.gov This electronic feature allows providers to submit claims directly to the department through Internet browser software with no additional hardware or software.

PROVIDER FORMS REQUEST

TYPE OR PRINT ALL ENTRIES

ORDER REQUEST DATE: ______________________ PROVIDER MEDICAID NUMBER: _____________________________

PROVIDER NAME: _______________________________________________________

STREET ADDRESS: ______________________________________________________ (CANNOT DELIVER TO POST OFFICE BOX)

CITY/STATE/ZIP: ________________________________ PHONE #: (_____) _____ -_______ ATTENTION OF: _____________________

PROVIDER E-MAIL ADDRESS: __________________________________ (Optional)

Enter the quantity of the forms being requested in increments of 100. Please be sure to indicate the total number of individual forms or envelopes needed in the Quantity column, not the number of boxes, cases or packages.

HFS Form Number:		QUANTITY:	Envelope Number:		QUANTITY:
215CF Drug Invoice, (Continuous Feed Format)		__________	824MCR Medicare Crossover		__________
1409	Prior Approval Request	__________	1414	Special Approval	__________
1443	Provider Invoice, (Single Sheet)	__________	1415	Drug Invoice	__________
1443CF Provider Invoice, (Continuous Feed Format)		__________	1416	Adjustments	__________
2209	Transportation Invoice, (Single Sheet)	__________	1444	Provider Invoice Envelope	__________
2209CF Transportation Invoice, (Continuous Feed Format)		__________	2244	Transportation Invoice	__________
2210	Medical Equipment / Supplies Invoice, (Single Sheet)	__________	2246	Health Agency Invoice	__________
2210CF Medical Equipment / Supplies Invoice, (Cont. Feed Format) __________			2247	Medical Equipment Supplies	__________
2211	Laboratory / Portable X-Ray Invoice, (Single Sheet)	__________	2248	NIPS Special Invoice Handling	__________
2211CF Laboratory / Portable X-Ray Invoice, (Cont. Feed Format)		__________	2294	Equip/Supplies Prior Approval	__________
2212	Health Agency Invoice, (Single Sheet)	__________	2300	Prior Approval Request	__________
2212CF Health Agency Invoice, (Continuous Feed Format)		__________	Additional Forms Needed, Not Listed Above:
2360	Health Insurance Claim Form, (Single Sheet)	__________	__________________________		__________
2360CF Health Insurance Claim Form, (Continuous Feed Format)		__________	__________________________		__________
3797	Medicare Crossover Invoice (Single Sheet)	__________	__________________________		__________
3797CF Medicare Crossover Invoice, (Continuous Feed Format)		__________	__________________________		__________

Submit this form by fax or mail to the address listed above.

HFS 1517 (R-9-10)

IL478-1023

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Form Hfs 1517 – Fill Out and Use This PDF

Form Hfs 1517 PDF Details

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