Medicare Subsidy Quality Review Case Analysis

Medicare Subsidy Quality Review Case Analysis

OMB: 0960-0707

IC ID: 9763

Documents and Forms
Document Name
Document Type
Instruction
Instruction
Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Medicare Subsidy Quality Review Case Analysis
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction SSA-9312.doc No   Paper Only
Form and Instruction SSA-9301 Medicare Subsidy Quality Review Case Analysis SSA-9301.doc This is completed electronically with an SSA employee who enters it electronically Yes Yes Fillable Fileable Signable
Form and Instruction SSA-9302 Notice of Appointment-Reviewer Will Call SSA-9302.doc No   Paper Only
Form and Instruction SSA-9303 Notice of Appointment-Please Call Reviewer SSA-9303.doc No   Paper Only
Instruction SSA-9311.doc No   Paper Only
Instruction SSA-9304.doc No   Paper Only

Income Security General Retirement and Disability

 

69,000 0
   
Individuals or Households
 
   14 %

  Requested 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 69,000 0 0 0 0 69,000
Annual IC Time Burden (Hours) 17,249 0 0 0 0 17,249
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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