WAG 22-06-07: Payment of Claims

PM 22-06-07

New Manual Material

New Manual Material

New Manual Material  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. New Manual Material Validate deceased individual's date of death is entered in IES.
  2. New Manual Material 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. New Manual Material Complete New Manual Material IL444-1619, Funeral and Burial Claim Report and the New Manual Material IL444-1959, Funeral/Burial Payment Request Notice.
  4. New Manual Material

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

  1. Adjust the claim.
  2. Use New Manual Material IL444-1959 to notify the claimant of the adjustment.
  3. Attach a copy of New Manual MaterialIL444-1959 to the claim.
  4. Process the adjusted claim for payment.

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

  1. Complete New Manual Material IL444-1959 to explain the problem and suggest corrections.
  2. Return claim and New Manual Material IL444-1959 to the claimant.
  3. Once resubmitted, process the claim for payment with a copy of the original New Manual Material 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  New Manual MaterialIllinois Department of Human Services allowance.

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

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