WAG 22-06-07: Payment of Claims

PM 22-06-07

  If a Vendor or Reimbursement claim is received in the FCRC, upon receipt, the claim should be date-stamped and sent to the Funeral and Burial Unit at DHS.FB@illinois.gov for processing.

The Funeral and Burial Unit:

When a claim is approved for payment:

1. Validate deceased individual's date of death is entered in IES.
2.  Ensure the deceased individual's case is cancelled or if included in a case with other household member's, ensure the individual has been properly removed from the existing case.
3.  Complete IL444-1619, Funeral and Burial Claim Report and the IL444-1959, Funeral/Burial Payment Request Notice.
4. 

When a claim cannot be paid as submitted but can be adjusted:

1. Adjust the claim.
2. Use IL444-1959 to notify the claimant of the adjustment.
3. Attach a copy of IL444-1959 to the claim.
4. Process the adjusted claim for payment.

When a claim cannot be paid because it is incorrect or incomplete:

1. Complete  IL444-1959 to explain the problem and suggest corrections.
2. Return claim and IL444-1959 to the claimant.
3. Once resubmitted, process the claim for payment with a copy of the original IL444-1959 attached.

When vendor charges are more than the maximum amount allowed:

1. Return the claim to the claimant pointing out the certification statement and the instructions on the back of the claim form.
2. Tell the funeral home that a reimbursement claim is appropriate.
3. Tell the vendor if they resubmit the claim it must have a separate statement from the funeral director certifying that the total charge has been reduced to the  Illinois Department of Human Services allowance.

When a request/claim for payment of funeral/burial expenses is denied:

1. Complete  IL444-1959, Funeral/Burial Payment Request Notice.
   1. Enter the reason for denial of the request or claim.
2. Send the original  IL444-1959 to the person requesting payment.
   1. 
   2. Upload a copy into the Electronic Case Record (ECR).