Providing health care information by telephone Forms for Chicago

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FAQ

Definition: The Patient Information Form (PIF) is used to collect demographic information as well as additional information about the impact of the event on a patient (e.g., level of harm, unplanned interventions).

Documents added using the Upload Documents page are added to the case, Work Item, or provider record and can be viewed by performing a document search on the Document Search page. Click on the Documents tab. From the Left Navigation menu, select Upload Documents. The Upload Documents page displays.

Illinois offers Medicaid coverage for people with disabilities with income up to 100% of the federal poverty level (monthly income of $1,012 for an individual) and non-exempt resources (assets) of no more than $2,000 (for one person).

Log into your CAFE portal account at . Click on My Applications tab. Click on Upload Documents..

Apply for Benefits Portal (ABE.Illinois.gov) You will need to set up an account, log in and fill out the online application. Supporting documents can also be uploaded after the application is signed and submitted.

The patient registration form, patient medical history, physical examination forms, laboratory results, diagnosis and treatment plans, operative reports, records of follow-up visits and telephone calls, hospital discharge summaries, consent forms, and correspondence with or about the patients are all documents that