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Get the free SFY2017 Interim DSH Notice of Intent to Transfer Form - dch georgia

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Georgia Department of Community Health SFY2017 Interim ASH Notice of Intent to Transfer Form Notices of Intent to Transfer form for ASH payment is due by Thursday, December 8, 2016. Intergovernmental
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How to fill out sfy2017 interim dsh notice

01
To fill out the SFY2017 interim DSH notice, follow these steps:
02
Start by gathering all the required information, including the hospital's name, address, and contact information.
03
Identify the hospital's fiscal year start and end dates for SFY2017.
04
Calculate the total amount of uncompensated care provided by the hospital during SFY2017.
05
Determine the amount of Medicaid eligible days for SFY2017.
06
Calculate the hospital-specific disproportionate share adjustment percentage for SFY2017.
07
Fill out the SFY2017 interim DSH notice form, providing all the necessary information and calculated values.
08
Double-check all the entered information to ensure accuracy.
09
Submit the completed SFY2017 interim DSH notice to the appropriate authority or organization.
10
Keep a copy of the filled-out form for your records.
11
Follow up if there are any additional requirements or actions needed after submitting the notice.

Who needs sfy2017 interim dsh notice?

01
The SFY2017 interim DSH notice is needed by hospitals that have provided uncompensated care and want to seek reimbursement through the Disproportionate Share Hospital (DSH) program.
02
Specifically, hospitals that have qualified for DSH payments in SFY2017 or plan to qualify for DSH payments in the future need to fill out and submit this notice.
03
It is important for hospitals to consult their local authorities or relevant organizations to determine if they are eligible and required to submit the SFY2017 interim DSH notice.
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The SFY2017 Interim DSH Notice is a notice that provides information about Disproportionate Share Hospital payments for the State Fiscal Year 2017.
Hospitals that receive Disproportionate Share Hospital payments are required to file the SFY2017 Interim DSH Notice.
To fill out the SFY2017 Interim DSH Notice, hospitals need to provide information about their Medicaid and uninsured patient volumes, as well as other relevant data.
The purpose of the SFY2017 Interim DSH Notice is to ensure that hospitals receive appropriate Disproportionate Share Hospital payments based on their Medicaid and uninsured patient populations.
Information such as Medicaid and uninsured patient volumes, Medicaid payments, and other relevant data must be reported on the SFY2017 Interim DSH Notice.
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2016 Georgia IGT DSH Annetta Intergovernmental SFY2017 asmithdch EFT providers gov Governmental entities Interim ACH affiliated ga participating provider

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