HH Demo for Mailed Requests (16 States)

Pre-Claim Review Demonstration For Home Health Services (CMS-10599)

OMB: 0938-1311

IC ID: 222825

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

View Information Collection (IC)

HH Demo for Mailed Requests (16 States)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction CMS-10599 - Home Health Instrument.pdf Yes No Printable Only

Health Health Care Services

 

13,221 0
   
Private Sector Not-for-profit institutions, 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 730,739 0 0 708,911 0 21,828
Annual IC Time Burden (Hours) 365,370 0 0 354,456 0 10,914
Annual IC Cost Burden (Dollars) 3,653,695 0 0 3,544,555 0 109,140

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

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