Healthcare Regulations Templates

This document is a template for an agreement between two organizations for an affiliation related to advanced life support. It provides a framework and terms for collaboration in providing advanced life support services.

This Form is used for institutional billing in nursing home facilities in Florida. It is also known as Form UB-04 or CMS-1450. The form is used to submit claims for reimbursement from Medicare, Medicaid, or other insurance providers for services provided to nursing home residents. The instructions provide guidance on how to complete the form accurately and submit it correctly.

This document is used to request a review or appeal of health care services in the state of Delaware. It allows individuals to contest decisions regarding their medical treatments or insurance coverage.

This document is for individuals or organizations applying for a Certificate of Need in the state of Connecticut. It includes all the necessary forms and instructions for the application process.

This document is used to notify the Florida Agency for Health Care Administration (AHCA) about a change in facility administrator. It is a required form for healthcare facilities in Florida.

This form is used for obtaining certification as an Advance Practice Nurse (APN) in Illinois. It also includes a collaborative agreement form for APNs.

This tool is used for reviewing provider relations in Missouri. It helps evaluate the relationships between healthcare providers and insurance companies in the state.

This document is used to outline the parameters for Registered Nurse (RN) supervision of Licensed Practical Nurses (LPN) in the state of Idaho. It describes the responsibilities and requirements for RNs overseeing the work of LPNs in healthcare settings.

This document is for foreign LPNs or RNs who want to become Certified Nurse Aides (CNAs) in Illinois.

This Form is used for applying for a Certificate of Need in Mississippi. It is required for individuals or organizations seeking to establish, expand, or modify certain healthcare facilities or services in the state.

This form is used for filing a complaint related to the Emergency Medical Systems Program in Nevada.

This form is used for applying for clinical privileges as an audiologist in the Air Force.

This form is used for reporting Mycobacterium isolates in the state of Washington. It is essential for tracking and monitoring the presence of this bacterium in the public health system.

This document is used to apply for registration for continuing care in the state of Rhode Island.

This document grants permission to share sensitive medical information in the state of Vermont.

Use this document, which is the patient's declaration - a written statement of what the patient expects to occur in the event of a serious accident or illness. It is primarily addressed for the medical personnel and focuses on the type of care the patient wishes to have in situations of terminal illness or incapacitation.

This form is used for facility requirements in California. It provides information and guidelines on the necessary requirements for facilities in the state.

This Form is used for requesting authorization for Makena medication under Fee for Service Medicaid in Texas.

This form is used for requesting a reconsideration of a prior authorization decision under the Texas Medicaid program.

This form is used for applying for an ambulatory surgical center license in the state of Texas.

This document provides instructions for completing Form FA-24A which is used for coordinating hospice services and waiver or personal care services (PCS) in Nevada.

This document is used for making adjustments to healthcare claims in the state of Virginia.

This document is a clinical practice inquiry specific to the state of New Hampshire. It likely contains information regarding healthcare practices, guidelines, or research relevant to medical professionals in the state.

This document outlines the self-insured employer's plan for managed care in South Dakota. It provides information on how employers can provide healthcare coverage to their employees through a managed care system.

This document is a sample checklist for South Carolina employees of SCDDSN (South Carolina Department of Disabilities and Special Needs) regarding the administration of buccal (oral) medication. It outlines the steps and requirements for properly handling and administering this type of medication.

This document for residents of South Carolina is used to justify the need for medical treatments or services. It is typically required by insurance companies to determine coverage eligibility.

This form is used for applying for a license to operate a hospital in the state of South Dakota.

This form is used for applying for a license to operate an ambulatory surgery center in South Dakota.

This type of document is for obtaining accreditation for rehabilitative behavioral health services in South Carolina.

This Form is used for pharmacists to apply for temporary registration in Nevada.

This form is used for applying for an adjustment to the scope-of-service rate for Federally Qualified Health Centers in Colorado. It also includes an attestation.