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This document provides instructions and forms for providers to certify their eligibility for a rate increase for primary care services under the Affordable Care Act, specifically targeting Medicaid

How to fill out certification and attestation for

How to fill out Certification and Attestation for Primary Care Rate Increase

1. Obtain the Certification and Attestation form from the appropriate health department or agency.
2. Review the instructions provided with the form for any specific guidelines or requirements.
3. Fill in your practice information, including your name, address, and contact details.
4. Indicate the type of primary care services you provide in the specified section.
5. Verify that you meet the eligibility criteria for the primary care rate increase.
6. Sign and date the form to affirm that all information provided is accurate and complete.
7. Submit the completed form to the designated agency or department by the specified deadline.

Who needs Certification and Attestation for Primary Care Rate Increase?

1. Primary care providers including physicians, nurse practitioners, and physician assistants who are eligible for increased reimbursement.

For pdfFiller’s FAQs

What is Certification and Attestation for Primary Care Rate Increase?

Certification and Attestation for Primary Care Rate Increase is a formal document that verifies compliance with regulations that mandate increases in payment rates for primary care services under specific healthcare programs.

Who is required to file Certification and Attestation for Primary Care Rate Increase?

Providers who deliver primary care services and seek to receive increased payment rates under applicable healthcare programs are required to file the Certification and Attestation.

How to fill out Certification and Attestation for Primary Care Rate Increase?

To fill out the Certification and Attestation, providers must complete the designated form by providing information regarding their practice, confirming eligibility for the rate increase, and certifying their compliance with required guidelines.

What is the purpose of Certification and Attestation for Primary Care Rate Increase?

The purpose of Certification and Attestation for Primary Care Rate Increase is to ensure that primary care providers are complying with established criteria to receive higher payment rates, ultimately aimed at enhancing the quality and access of primary care services.

What information must be reported on Certification and Attestation for Primary Care Rate Increase?

The information that must be reported includes provider identification details, services provided, attestation of meeting the required criteria for rate increases, and any additional documentation as specified by the regulating authority.