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January 2016 Dear Provider, Maintain providers wishing to receive the primary care payment increase must fill out and submit the attached PCP Increase SelfAttestation form. Please note that hospitals,
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Letter and attestation form is a document used to certify that certain information is true and accurate.
Certain individuals or entities may be required to file the letter and attestation form, depending on the specific requirements of the situation.
The letter and attestation form can be filled out by providing the requested information in the designated fields on the form.
The purpose of the letter and attestation form is to provide a certification of the accuracy of certain information.
The information that must be reported on the letter and attestation form will vary depending on the specific requirements of the situation.
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