Get the free OMB 0938-1279 TRANSFER - Professional Nursing Service

OMB #09381279 TRANSFER (M0010) CMS Certification Number: 367549 (M0014) Branch State: OH (M0016) Branch ID Number: N/A Patient Identifiers: Facial Recognition Patient Address DOB (month/day year)

How to fill out omb 0938-1279 transfer

How to Fill out OMB 0938-1279 Transfer:

1. Gather the required documents: Before filling out the OMB 0938-1279 Transfer form, make sure you have all the necessary documents handy. These may include your identification documents, relevant medical records, or any other supporting paperwork.
2. Fill in your personal information: Begin by providing your personal details accurately. This may include your full name, date of birth, contact information, and Social Security number. Ensure all the information you provide matches the details on your official records.
3. Indicate the reason for the transfer: In the form, you will need to specify the reason for the transfer. Whether it is a change in insurance coverage, a shift in medical facilities, or any other reason, clearly state the purpose behind your transfer request.
4. Provide details about the old facility/provider: If you are transferring from a previous medical facility or provider, include their name, address, and contact information in the designated fields. This information will help facilitate the transfer process smoothly.
5. Enter information about the new facility/provider: Similarly, provide the name, address, and contact details of the new medical facility or provider where you wish to transfer your records. Double-check this information to ensure its accuracy.
6. Attach any necessary supporting documentation: If there are any supporting documents required for the transfer, make sure to attach them securely to the form. These documents may include referral letters, medical histories, or any other paperwork requested by your new medical facility.
7. Review and verify your information: Before submitting the form, carefully review all the information you have provided. Check for any errors, omissions, or inconsistencies. It is essential to ensure the accuracy of your data to avoid any delays or complications in the transfer process.

Who needs OMB 0938-1279 Transfer?

The OMB 0938-1279 Transfer form is typically required by individuals who wish to transfer their medical records from one facility or provider to another. This form is commonly used when changing healthcare providers, moving to a different location, or transitioning to a new insurance plan. Additionally, it may be necessary for patients seeking specialized care or a second opinion from another healthcare institution. The form ensures a seamless transfer of medical information, allowing the new provider to have access to the patient's complete medical history and records.

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What is omb 0938-1279 transfer?

The omb 0938-1279 transfer refers to the process of transferring information related to a specific healthcare program overseen by the Office of Management and Budget (OMB).

Who is required to file omb 0938-1279 transfer?

Entities involved in the healthcare program that fall under the jurisdiction of the OMB are required to file the omb 0938-1279 transfer.

How to fill out omb 0938-1279 transfer?

The omb 0938-1279 transfer form must be filled out accurately and completely, providing all the required information as specified by the OMB.

What is the purpose of omb 0938-1279 transfer?

The purpose of omb 0938-1279 transfer is to ensure that relevant information is transferred efficiently and securely for proper oversight and management of the healthcare program.

What information must be reported on omb 0938-1279 transfer?

The omb 0938-1279 transfer form typically requires details such as program specifics, financial data, and any other pertinent information deemed necessary by the OMB.