User Acceptance Testing for the Medicare Ground Ambulance Data Collection System (GADCS) (CMS-10754)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (CMS-10415)

OMB: 0938-1185

IC ID: 257137

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

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User Acceptance Testing for the Medicare Ground Ambulance Data Collection System (GADCS) (CMS-10754)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10754 GADCS Feedback Application GADCS Draft Feedback v2.docx Yes Yes Fillable Fileable
Instruction GADCS User Guide (1).docx Yes No Printable Only
Form and Instruction CMS-10754 Observed Testing Protocol Instrument Testing_Interview Protocol_.docx Yes Yes Fillable Printable

Health Health Care Services

 

60 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   100 %

  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 60 0 60 0 0 0
Annual IC Time Burden (Hours) 120 0 120 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CMS-10754 - Fast Track Supporting Statement CMS-10754 - Fast Track Supporting Statement (1).docx 11/28/2022
Round 2 UAT Recruitment email v2 Round 2 UAT Recruitment email v2.docx 11/28/2022
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