Agencies
Services
Ambulatory Surgical Treatment Centers
Ambulatory Surgical Treatment Centers are any institution or building devoted primarily to the maintenance and operation of facilities for the performance of surgical procedures, as evidenced by use of the facilities by physicians, podiatrists or dentists in the performance of surgical procedures that constitutes more than 50 percent of the activities at that location.
How to Become Medicare Certified
Complaints
For information on filing a complaint or checking the status of a current complaint, please visit our complaint section.
Health Care Credentialing
The Health Care Credentials and Data Collection Act requires uniform forms to be utilized in order to collect the credentials data commonly requested by health care entities and health care plans for purposes of credentialing and recredentialing. The forms required for use by the Health Care Professional Credentialing and Data Collection Act (410 ILCS 517) are located under the Forms section on the right-hand side of this page.
"These forms are for use with the entity or entities that are conducting the credentialing. DO NOT SEND COMPLETED FORMS TO THE STATE. Please contact the health care plan, health care entity or hospital that is reviewing your credentials for instructions on where to send this form and any other information it may require in order to complete the credentialing process."
Frequently Asked Questions
What is required for a relocation of the health care provider?
When the agency is seeking to relocate the health care provider’s facility location, the provider shall contact the Health Facilities Service Review Board. See link. In addition, if the Facility is Medicare certified the provider shall complete the Medicare Provider enrollment form B and submit to their Medicare fiscal intermediary.
Resources
Forms
- Medicare Intermediary Information
- Ambulatory Surgical Treatment Center License Application
- Ambulatory Surgical Treatment Center License Renewal Application
- Ambulatory Surgical Treatment Center Medicare Certification
- Health Care Professional Update Data Gathering Form
- Health Care Professional Credentialing and Data Gathering Form
- Health Care Professional Recredentialing and Data Gathering Form