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PRINTED: 02/26/2016 FORM APPROVED DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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Gather all necessary information and documentation such as personal identification, Medicare number, and medical records.
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Centers for Medicare & Medicaid Services (CMS) is a federal agency that administers the Medicare program and works with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
Healthcare providers and suppliers who are enrolled in the Medicare program are required to file Centers for Medicare & Medicaid Services (CMS) forms.
Centers for Medicare & Medicaid Services (CMS) forms can be filled out electronically on the CMS website or submitted through the mail.
The purpose of Centers for Medicare & Medicaid Services (CMS) forms is to report information about healthcare services provided to Medicare beneficiaries.
Information such as patient demographics, diagnoses, procedures, and charges must be reported on Centers for Medicare & Medicaid Services (CMS) forms.
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