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Eligible Professional Attestation Worksheet for Modified Stage 2 of the Medicare Electronic Health Record (EHR) Incentive Program in 2016 The Eligible Professional (EP) Attestation Worksheet is for

How to fill out eligible professional attestation worksheet

How to fill out eligible professional attestation worksheet:

1. Download the eligible professional attestation worksheet from the appropriate website or source.
2. Fill in your personal information in the designated areas, such as your full name, contact information, and professional credentials.
3. Indicate your eligible professional category by selecting the relevant option or providing the required information.
4. Specify the reporting period for which you are submitting the attestation by providing the start and end dates.
5. Review the attestation statements carefully and check the appropriate box or provide the necessary information to indicate your compliance with each statement.
6. If any of the attestation statements do not apply to your situation, provide the appropriate information or select the "Not Applicable" option.
7. Sign and date the attestation worksheet to certify the accuracy of the information provided.
8. Keep a copy of the completed eligible professional attestation worksheet for your records.

Who needs eligible professional attestation worksheet:

1. Eligible professionals participating in certain healthcare programs, such as the Medicare Electronic Health Record (EHR) Incentive Program or the Merit-Based Incentive Payment System (MIPS), may need to complete an eligible professional attestation worksheet.
2. Healthcare providers who meet the eligibility criteria and are seeking to demonstrate their compliance with specific program requirements may be required to submit this worksheet.
3. Eligible professionals looking to attest to their meaningful use of certified EHR technology, report quality measures, or meet other program objectives may need to fill out an eligible professional attestation worksheet.

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What is eligible professional attestation worksheet?

The eligible professional attestation worksheet is a document used to attest to meeting certain requirements for a professional to qualify for incentives or bonuses in healthcare programs.

Who is required to file eligible professional attestation worksheet?

Healthcare professionals who are eligible for incentives or bonuses in healthcare programs are required to file the eligible professional attestation worksheet.

How to fill out eligible professional attestation worksheet?

The eligible professional attestation worksheet can be filled out by providing the necessary information and signatures to attest to meeting the requirements.

What is the purpose of eligible professional attestation worksheet?

The purpose of the eligible professional attestation worksheet is to verify that a healthcare professional meets the requirements for incentives or bonuses in healthcare programs.

What information must be reported on eligible professional attestation worksheet?

The eligible professional attestation worksheet must include information about the healthcare professional's qualifications, achievements, and compliance with program requirements.