Medicare Collection Of Medical Information On Home Health Services On Forms Hcfa 485-487 And Intermediary Request For Medical Information On Claims To Be Processed

MEDICARE COLLECTION OF MEDICAL INFORMATION ON HOME HEALTH SERVICES ON FORMS HCFA 485-487 AND INTERMEDIARY REQUEST FOR MEDICAL INFORMATION ON CLAIMS TO BE PROCESSED

OMB: 0938-0357

IC ID: 113524

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MEDICARE COLLECTION OF MEDICAL INFORMATION ON HOME HEALTH SERVICES ON FORMS HCFA 485-487 AND INTERMEDIARY REQUEST FOR MEDICAL INFORMATION ON CLAIMS TO BE PROCESSED
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-486 No No
Form HCFA-487 No No
Form HCFA-485 No No


    

6,800 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 6,115,288 0 0 0 0 6,115,288
Annual IC Time Burden (Hours) 2,916,992 0 0 0 0 2,916,992
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
 
 
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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