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 198905-0938-001

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 198905-0938-001
Historical Active 198512-0938-005
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
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 06/29/1989
Retrieve Notice of Action (NOA) 05/03/1989
  Inventory as of this Action Requested Previously Approved
06/30/1992 06/30/1992
30,474 0 0
7,617 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 30,474 0 0 0 30,474 0
Annual Time Burden (Hours) 7,617 0 0 0 7,617 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.
05/03/1989


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