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This form is used for cost apportionment of inpatient ancillary services in healthcare facilities, allowing providers to report costs, charges, and related information for various service categories.
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How to fill out cms-2552-96

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How to fill out CMS-2552-96

01
Obtain the CMS-2552-96 form from the CMS website or your local Medicare office.
02
Begin filling out the header section with the name of the facility, address, and CMS certification number.
03
Provide the reporting period for which you are requesting cost report information.
04
Fill out the section that outlines the general information about the facility, including ownership and type of services provided.
05
Complete the cost reporting section by detailing the applicable costs incurred during the reporting period.
06
Make sure to include all necessary schedules as required, such as those for salaries, expenses, and equipment.
07
Review the data to ensure accuracy and completeness before submission.
08
Sign and date the form to certify that the information provided is true and correct.

Who needs CMS-2552-96?

01
Healthcare facilities and providers seeking reimbursement from Medicare for services rendered.
02
Organizations that need to report their costs and reimbursement amounts to the Centers for Medicare & Medicaid Services.
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CMS-2552-96 is a form used by healthcare providers to report costs and request reimbursement from Medicare for services provided to beneficiaries under the Medicare program.
Healthcare providers, specifically those that operate as skilled nursing facilities or home health agencies, are required to file CMS-2552-96 for reimbursement from Medicare.
To fill out CMS-2552-96, providers must gather necessary financial data, follow the instructions provided with the form, complete all sections accurately, and ensure supporting documentation is attached before submission.
The purpose of CMS-2552-96 is to allow healthcare providers to report their costs associated with patient care and seek reimbursement from Medicare for eligible services covered under the program.
CMS-2552-96 requires providers to report detailed financial information, including costs related to patient care, administrative expenses, direct and indirect costs, and any other relevant data needed for Medicare reimbursement calculations.
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