Documents
59
Form CMS-853 Certificate of Medical Necessity
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(4.3 / 5) 58 votes Size: 63 KB
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File this form to document that the use of the medical equipment used for enteral nutrition is justified. This part of the procedure is called the medical necessity, which is a way to have Medicare compensate the costs of items and services that are considered necessary.
Form CMS-485 Home Health Certification and Plan of Care
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(4.4 / 5) 42 votes Size: 31 KB
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This form is filled out by the patient's attending physician and used as a fiduciary document in order to authorize professional health services.
Form CMS-671 Long-Term Care Facility Application for Medicare and Medicaid
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(4.8 / 5) 59 votes Size: 66 KB
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Form CMS-40B Solicitud De Inscripcion Para Medicare Parte B (Seguro Medico)
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(4.4 / 5) 69 votes Size: 62 KB
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Form CMS-116 Clinical Laboratory Improvement Amendments (Clia) - Application for Certification
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(4.6 / 5) 25 votes Size: 267 KB
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Form CMS-849 Certificate of Medical Necessity - Seat Lift Mechanisms
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(4.3 / 5) 79 votes Size: 142 KB
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Form CMS-847 Certificate of Medical Necessity - Osteogenesis Stimulators
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(4.4 / 5) 44 votes Size: 179 KB
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Form CMS-381 Model Letter Requesting Identification of Extension Locations
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(4.7 / 5) 63 votes Size: 54 KB
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Form CMS-R 285 Request for Retirement Benefit Information
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(4.5 / 5) 42 votes Size: 68 KB
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Form CMS-846 Certificate of Medical Necessity - Pneumatic Compression Devices
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(4.8 / 5) 36 votes Size: 108 KB
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Form CMS-848 Certificate of Medical Necessity - Transcutaneous Electrical Nerve Stimulator (Tens)
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(4.3 / 5) 77 votes Size: 133 KB
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Form CMS-854 Certificate of Medical Necessity -continuation Form
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(4.8 / 5) 59 votes Size: 117 KB
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Form HCFA-605 Request for Approval as a Hospital Provider of Extended Care Services (Swing-Bed) in the Medicare and Medicaid Programs
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(4.7 / 5) 57 votes Size: 18 KB
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Form CMS-1763 Request for Termination of Premium Hospital and/Or Supplementary Medical Insurance
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(4.6 / 5) 98 votes Size: 65 KB
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Form CMS-437B Rehabilitation Hospital Criteria Work Sheet
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(4.7 / 5) 79 votes Size: 171 KB
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Form CMS 1696 Appointment of Representative - Large Print
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(4.4 / 5) 63 votes Size: 27 KB
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Form CMS-437b Rehabilitation Hospital Criteria Work Sheet
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(4.5 / 5) 42 votes Size: 161 KB
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Form CMS-3427 End Stage Renal Disease Application and Survey and Certification Report
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(4.7 / 5) 18 votes Size: 172 KB
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Form CMS-10106 1-800-medicare Authorization to Disclose Personal Health Information
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(4.8 / 5) 42 votes Size: 123 KB
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Form CMS-10106 Autorizacion a 1-800-medicare Para La Divulgacion De Informacion Medica Personal
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(4.3 / 5) 40 votes Size: 126 KB
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Form CMS-10126 Dme Information Form - Enteral and Parenteral Nutrition
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(4.5 / 5) 70 votes Size: 120 KB
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Form CMS-R-0235A Data Use Agreement (Dua) Signature Addendum for Data Acquired From the Centers for Medicare & Medicaid Services (Cms)
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(4.3 / 5) 72 votes Size: 193 KB
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Form CMS-10455 Report of a Hospital Death Associated With Restraint or Seclusion
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(4.8 / 5) 67 votes Size: 116 KB
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Form CMS-2786Y Fire Safety Evaluation System - Intermediate Care Facilities for Individuals With Intellectual Disabilities (Small Facilities) - 2012 Life Safety Code
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(4.3 / 5) 44 votes Size: 121 KB
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