MEDICARE - INFORMATION COLLECTION REQUIREMENTS IN HCFA-PUB. 14-3 CARRIER MANUAL SECTIONS 2070.2, 3060.2.D., 4110.2 AND 4110.4 - PHYSICIAN/SUPPLIER BACKGROUND INFORMATION

ICR 198512-0938-005

OMB: 0938-0461

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0461 198512-0938-005
Historical Active
HHS/CMS
MEDICARE - INFORMATION COLLECTION REQUIREMENTS IN HCFA-PUB. 14-3 CARRIER MANUAL SECTIONS 2070.2, 3060.2.D., 4110.2 AND 4110.4 - PHYSICIAN/SUPPLIER BACKGROUND INFORMATION
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 02/28/1986
Retrieve Notice of Action (NOA) 12/31/1985
  Inventory as of this Action Requested Previously Approved
02/28/1989 02/28/1989
26,609 0 0
6,652 0 0
0 0 0

THE CARRIER NEEDS TO DETERMINE PHYSICIAN/SUPPLIER COMPLIANCE WITH REQUIREMENTS BEFORE CLAIMS PROCESSING CAN BEGIN. SECTIONS IN THE CARRI MANUAL IDENTIFIES THOSE AREAS IN WHICH THE CARRIER CAN REQUEST BACKGROUND INFORMATION FROM PHYSICIANS/SUPPLIERS IN ORDER TO DETERMINE COMPLIANCE PRIOR TO THE CLAIMS PROCESSING.

None
None


No

  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 26,609 0 0 0 26,609 0
Annual Time Burden (Hours) 6,652 0 0 0 6,652 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.
12/31/1985


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