Get the free FORM HCFA-2552-96

Worksheet D is designed for the apportionment of various types of inpatient costs within hospitals. It covers capital costs for routine and ancillary services, providing detailed instructions for

How to fill out form hcfa-2552-96

How to fill out FORM HCFA-2552-96

1. Obtain a copy of Form HCFA-2552-96.
2. Read the instructions provided with the form to understand the requirements.
3. Fill out the identification section with the provider's information including name, address, and provider number.
4. Complete the cost report section, entering financial data for the specified reporting period.
5. Provide details on services rendered and patient data in the designated sections.
6. Include all necessary supporting documentation as specified in the instructions.
7. Review the completed form for accuracy and completeness.
8. Sign and date the form certifying that the information provided is true and accurate.
9. Submit the form to the appropriate Medicare administrative contractor by the deadline.

Who needs FORM HCFA-2552-96?

1. Healthcare providers who participate in Medicare and are required to report their costs.
2. Facilities such as rural health clinics, skilled nursing facilities, and home health agencies.

People Also Ask about

Does Medicare use CMS 1500?

The Form CMS-1500 is the standard paper claim form to bill Medicare Fee-For-Service (FFS) Contractors when a paper claim is allowed. In addition to billing Medicare, the 837P and Form CMS-1500 may be suitable for billing various government and some private insurers.

Does Medicare accept the CMS 1500 claim form?

Medicare Part 2, Provider Cost Reporting Forms and Instructions, Chapter 40, Form CMS-2552-10. This transmittal updates Chapter 40, Hospital and Hospital Health Care Complex Cost Report (Form CMS-2552-10), by clarifying and revising the existing instructions and by revising existing edits.

What form is used to send claims to Medicare?

How do I file a claim? You can download and fill out a form, called the Patient Request for Medical Payment form (CMS-1490S). This form is also available in Spanish.

In which of the following would a CMS 1500 claim form be used?

The Health Insurance Claim Form (CMS-1500) is used by Allied Health professionals, physicians, laboratories and pharmacies to bill supplies and services to the Medi-Cal program.

Is Medicare accepting paper claims?

The Administrative Simplification Compliance Act (ASCA) requires that Medicare claims be sent electronically unless certain exceptions are met. Providers meeting an ASCA exception may send their claims to Medicare on a paper claim form.

For pdfFiller’s FAQs

What is FORM HCFA-2552-96?

FORM HCFA-2552-96 is the Health Care Financing Administration's cost report form for hospitals and providers seeking reimbursement from Medicare for services provided.

Who is required to file FORM HCFA-2552-96?

Providers of services, such as hospitals and skilled nursing facilities, that participate in the Medicare program and are reimbursed on a cost basis are required to file FORM HCFA-2552-96.

How to fill out FORM HCFA-2552-96?

To fill out FORM HCFA-2552-96, providers must gather financial records, including costs and patient data, and accurately report their operations according to the instructions provided with the form, ensuring all sections and schedules are completed as required.

What is the purpose of FORM HCFA-2552-96?

The purpose of FORM HCFA-2552-96 is to report the costs incurred by healthcare providers in delivering services to Medicare patients, which is used to determine reimbursement rates.

What information must be reported on FORM HCFA-2552-96?

Information reported on FORM HCFA-2552-96 includes financial data such as total patient care costs, revenue, ownership details, and various operational statistics, along with supporting schedules.