MEDICARE: SUPPORTING STATEMENT FOR REQUEST FOR MEDICAL REVIEW INFORMATION FOR PART B OUTPATIENT BILLS

ICR 199009-0938-012

OMB: 0938-0549

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0549 199009-0938-012
Historical Active 198906-0938-009
HHS/CMS
MEDICARE: SUPPORTING STATEMENT FOR REQUEST FOR MEDICAL REVIEW INFORMATION FOR PART B OUTPATIENT BILLS
Revision of a currently approved collection   No
Regular
Approved without change 12/03/1990
Retrieve Notice of Action (NOA) 09/06/1990
  Inventory as of this Action Requested Previously Approved
06/30/1991 06/30/1991 10/31/1990
4,649,835 0 4,649,831
2,324,917 0 2,324,915
0 0 0

MEDICARE CONTRACTORS REQUIRE CERTAIN MEDICAL INFORMATION TO DETERMINE THAT REQUIREMENTS FOR MEDICARE COVERAGE ARE MET. THE INFORMATION IS USED TO DETERMINE IF BILLED SERVICES ARE PAYABLE IN ACCORDANCE WITH MEDICAL LAW, REGULATIONS AND GUIDELINES. THE SERVICES IN QUESTION MAY BE PROVIDED BY HOSPITALS, SNFS, CORFS, RUC, HOSPICES, ESRD FACILITIES, AND CHRISTIAN SCIENCE HOSPITALS AND SNFS.

None
None


No

1
IC Title Form No. Form Name
MEDICARE: SUPPORTING STATEMENT FOR REQUEST FOR MEDICAL REVIEW INFORMATION FOR PART B OUTPATIENT BILLS HCFA-9027

  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 4,649,835 4,649,831 0 0 4 0
Annual Time Burden (Hours) 2,324,917 2,324,915 0 0 2 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.
09/06/1990


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