The Illinois Department of Public Health completes Form IL-482-0634, Prenatal Care Program, to verify expenses paid by their Prenatal Program. Contact the local Public Health agency to verify the date of payment if the date of payment is not provided
on the form.
The Division of Specialized Care for Children (DSCC) provides an Explanation of Benefits to verify expenses paid by them.
Use payments made by someone not in the MANG standard for any month the bill is the client's liability, beginning with the month the service is received, through 6 months following the month the bill was paid.
Illinois Department of Human ServicesJB Pritzker, Governor · Grace B. Hou, Secretary
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