CMS-10432 Vendor Authorization Screen Shot

Inpatient Psychiatric Facility Quality Reporting Program

CMS IPF Vendor Auth Screen Shots_final_508

Inpatient Psychiatric Facility Quality Reporting Program

OMB: 0938-1171

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VENDOR AUTHORIZATION

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VENDOR AUTHORIZATION

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VENDOR AUTHORIZATION

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VENDOR AUTHORIZATION

These screen shots are for the Vendor Authorization function, which is expected to go live as part of the
Hospital Reporting tool set by June 27, 2013. These screen shots are mock-ups of the expected
functionality, which is still in development, and may not be fully representative. A paper-based form will
also be submitted in the PRA package.

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File Typeapplication/pdf
File TitleVENDOR AUTHORIZATION
AuthorCaroline P. Miller
File Modified2013-05-14
File Created2013-05-14

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