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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Form Approved OMB No. 0938-0679 CERTIFICATE OF MEDICAL NECESSITY CMS-854 -- CONTINUATION FORM PATIENT NAME PATIENT

How to fill out omb no 0938 0679

How to fill out omb no 0938 0679:

1. Obtain the omb no 0938 0679 form from the relevant authority or website.
2. Read the instructions provided on the form carefully to understand the required information and any specific guidelines for filling it out.
3. Fill in your personal information accurately and completely in the designated fields, including your name, address, contact details, and any other information requested.
4. Provide any necessary identification or supporting documents as mentioned in the instructions, such as a copy of your ID or proof of eligibility.
5. Review the completed form to ensure all information is correct and all fields are appropriately filled.
6. Sign and date the form where required.
7. Submit the filled-out omb no 0938 0679 form through the designated method mentioned in the instructions, such as mail, online submission, or in-person submission.

Who needs omb no 0938 0679:

1. Individuals applying for a specific benefit, program, or service that requires completion of omb no 0938 0679.
2. Organizations or institutions that are instructed to collect and submit omb no 0938 0679 forms on behalf of individuals.
3. Any person or entity that is obligated by law or regulation to provide the requested information on omb no 0938 0679.

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What is omb no 0938 0679?

OMB No. 0938-0679 is a form used by the Centers for Medicare & Medicaid Services (CMS) in the United States.

Who is required to file omb no 0938 0679?

Healthcare providers and organizations that participate in the Medicare and Medicaid programs are typically required to file OMB No. 0938-0679.

How to fill out omb no 0938 0679?

The specific instructions for filling out OMB No. 0938-0679 can be found on the official CMS website or in the accompanying documentation provided by CMS.

What is the purpose of omb no 0938 0679?

The purpose of OMB No. 0938-0679 is to gather necessary information from healthcare providers and organizations participating in the Medicare and Medicaid programs for various administrative and regulatory purposes.

What information must be reported on omb no 0938 0679?

The specific information that must be reported on OMB No. 0938-0679 will depend on the specific form being used and the applicable regulations. Typically, it includes information related to the provider's identification, services rendered, billing details, and compliance with program requirements.