Institutions (non-hospital) questionnaire

Medical Expenditure Panel Survey - Household and Medical Provider Components

OMB: 0935-0118

IC ID: 191106

Documents and Forms

Document Name Document Type
Form Attachment 96 Institutions (non-hospital) questionnaire Form and Instruction
Attachment 96 Attachment 96 – MPC Institution Provider Questionnaire Attachment 96 – MPC Institution Provider Questionnaire.docx Form and Instruction
Attachment 88 MPC Hospital_MRPA_AF_Packet.doc Attachment 88 – MPC Hospital Provider Authorization Form Package, One Point of Contact for Medical and Patient Account Records IC Document
Attachment 89 MPC Hospital_MR_AF_Packet.doc Attachment 89 – MPC Hospital Provider Authorization Form Package, Point of Contact for Medical Records IC Document
Attachment 90 MPC Hospital_PA_AF_Packet.doc Attachment 90 – MPC Hospital Provider Authorization Form Package, Point of Contact for Patient Account Records IC Document
Attachment 91 MPC Hospital_Overflow_Patient_List.docx Attachment 91 – MPC Hospital Provider Overflow Patient List IC Document
Attachment 93 MPC Letter.docx Attachment 93 – MPC Letters, Email Templates, and Other Documents IC Document