329 REQUIREMENT FOR NARRATIVE NOTATION OF HOME HEALTH VISIT IN MEDICAL RECORDS

ICR 198310-0938-026

OMB: 0938-0188

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
0938-0188 198310-0938-026
Historical Active 198305-0938-007
HHS/CMS
329 REQUIREMENT FOR NARRATIVE NOTATION OF HOME HEALTH VISIT IN MEDICAL RECORDS
Revision of a currently approved collection   No
Regular
Approved without change 12/15/1983
Retrieve Notice of Action (NOA) 10/19/1983
  Inventory as of this Action Requested Previously Approved
10/31/1985 10/31/1985 10/31/1983
13,600 0 3,216
4,523 0 1,071
0 0 0

DETAILED CLINICAL NOTES ON EACH HOME HEALTH VISIT ARE REQUIRED IN ORDER TO DETERMINE IF VISITS ARE COVERED BY MEDICARE.

None
None


No

1
IC Title Form No. Form Name
329 REQUIREMENT FOR NARRATIVE NOTATION OF HOME HEALTH VISIT IN MEDICAL RECORDS HCFA-296

  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 13,600 3,216 0 10,384 0 0
Annual Time Burden (Hours) 4,523 1,071 0 3,452 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
10/19/1983


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