CONTRACTORS INFORMATION COLLECTIONS CLAIMS PROCESSING DATA COLLECTED FROM HOSPITALS

ICR 198310-0938-017

OMB: 0938-0224

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0938-0224 198310-0938-017
Historical Active 198112-0938-004
HHS/CMS
CONTRACTORS INFORMATION COLLECTIONS CLAIMS PROCESSING DATA COLLECTED FROM HOSPITALS
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 11/14/1983
Retrieve Notice of Action (NOA) 10/31/1983
  Inventory as of this Action Requested Previously Approved
09/30/1984 09/30/1984
2,600,000 0 0
433,333 0 0
0 0 0

THIS INFORMATION IS COLLECTED FROM HOSPITALS BY THE CONTRACTOR DURING CLAIMS REVIEW. IT CONCERNS PSYCHIATRIC BILLING, CAT SCANS, MEDICAL INFORMATION, LATE CLAIMS & DUPLICATE CLAIMS.

None
None


No

1
IC Title Form No. Form Name
CONTRACTORS INFORMATION COLLECTIONS CLAIMS PROCESSING DATA COLLECTED FROM HOSPITALS HCFA-9026

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,600,000 0 0 0 2,600,000 0
Annual Time Burden (Hours) 433,333 0 0 0 433,333 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/31/1983


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