Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc) / Rural Health Center (Rhc) Prospective Payment System (Pps) - California

Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc) / Rural Health Center (Rhc) Prospective Payment System (Pps) - California

This document contains official instructions for Form DHCS3096 , Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc)/Rural Health Center (Rhc) Prospective Payment System (Pps) - a form released and collected by the California Department of Health Care Services.

FAQ

Q: What is Form DHCS3096?A: Form DHCS3096 is the Medi-Cal Cost Report - Change in Scope-Of-Service Request (CSOSR) for Freestanding Federally Qualified Health Center (FQHC)/Rural Health Center (RHC) Prospective Payment System (PPS) in California.

Q: What is a CSOSR?A: CSOSR stands for Change in Scope-Of-Service Request. It is a form that needs to be filled for Medi-Cal Cost Report when requesting a change in the scope of services for a Federally Qualified Health Center (FQHC) or Rural Health Center (RHC) under the Prospective Payment System (PPS).

Q: Who needs to fill out Form DHCS3096?A: Federally Qualified Health Centers (FQHCs) or Rural Health Centers (RHCs) in California who are under the Prospective Payment System (PPS) need to fill out Form DHCS3096.

Q: What is the purpose of Form DHCS3096?A: The purpose of Form DHCS3096 is to request a change in the scope of services for a Freestanding Federally Qualified Health Center (FQHC) or Rural Health Center (RHC) under the Prospective Payment System (PPS) in California.

Q: Is Form DHCS3096 specific to California?A: Yes, Form DHCS3096 is specific to California and is used for Medi-Cal Cost Reporting for Freestanding Federally Qualified Health Centers (FQHCs) or Rural Health Centers (RHCs) under the Prospective Payment System (PPS).

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Instruction Details:

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  • Actual and applicable for the current year;
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  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc)/Rural Health Center (Rhc) Prospective Payment System (Pps) - California

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  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc)/Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 2

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  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc)/Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 3

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  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc)/Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 4

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  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc)/Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 5

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  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc)/Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 6

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  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc)/Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 7

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  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc)/Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 8

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  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc)/Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 9

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  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc)/Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 10

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  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc) / Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 1
  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc) / Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 2
  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc) / Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 3
  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc) / Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 4
  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc) / Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 5
  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc) / Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 6
  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc) / Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 7
  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc) / Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 8
  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc) / Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 9
  • Instructions for Form DHCS3096 Medi-Cal Cost Report - Change in Scope-Of-Service Rquest (Csosr) Freestanding Federally Qualified Health Center (Fqhc) / Rural Health Center (Rhc) Prospective Payment System (Pps) - California, Page 10
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