Information Collection

329 Requirement For Narrative Notation Of Home Health Visit In Medical Records

IC 113056 under ICR 198310-0938-026 · OMB 0938-0188.

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Information Collection (IC) Details

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IC Title:	329 REQUIREMENT FOR NARRATIVE NOTATION OF HOME HEALTH VISIT IN MEDICAL RECORDS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-296				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 480	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	13,600	10,384	3,216
Annual IC Time Burden (Hours)	4,523	3,452	1,071
Annual IC Cost Burden (Dollars)	0	0	0

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