MedicaidAdministrativeLow impact
HFS 3864, Screening Verification Form
Illinois Medicaid - HFS·IL · Geriatrics·Provider Notice
Effective date
Jul 31, 2008
We identified it
Jun 21, 2026
Summary
Illinois Department of Healthcare and Family Services introduced Form HFS 3864 to help nursing facilities verify screening documentation when residents transfer between facilities and original screening records are unavailable. This form allows admitting facilities to obtain screening verification from the Department on Aging database.
Action Required
This is a 2008 policy for nursing facilities only. No action required for typical medical billing teams unless your practice operates or bills for nursing facility services in Illinois.