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Information Collection

Establishing Procedures For Transmitting Information Between Medicare Carriers And Medicare Supplemental Insurers

IC 114005 under ICR 199311-0938-006 · OMB 0938-0571.

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ESTABLISHING PROCEDURES FOR TRANSMITTING INFORMATION BETWEEN MEDICARE CARRIERS AND MEDICARE SUPPLEMENTAL INSURERS
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-R-140 No No


    

1 0
   
Individuals or Households
 
   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 50 0 50 0 0 0
Annual IC Time Burden (Hours) 4,491,425 0 4,491,425 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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