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PTID Only one 1 PTID for Service/Item per fax cover sheet. MEDICAID ID TYPE OF SERVICE/ITEM Select only one CMWC Assessment Occupational Therapy Assessment CMWC Service DME - Gait Trainer DME - Orthotic Device Physical Therapy Assessment DME - Prosthetic Device DME - Positioning Wedge Speech Therapy Assessment DME - Special Needs Car Seat or Travel Restraint DME - Standing Board/Frame IMPORTANT This fax cover sheet must be used when submitting attachments signature sheets receipt confirmation...
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What is fax cover sheet?
A fax cover sheet is a document that is sent along with a fax transmission to provide information to the recipient.
Who is required to file fax cover sheet?
Anyone sending a fax transmission can choose to include a fax cover sheet.
How to fill out fax cover sheet?
To fill out a fax cover sheet, include sender and recipient information, a brief message, and any additional notes or instructions.
What is the purpose of fax cover sheet?
The purpose of a fax cover sheet is to provide context and relevant information to the recipient of the fax transmission.
What information must be reported on fax cover sheet?
Sender's name, recipient's name, fax number, date, number of pages, and a brief message should be reported on a fax cover sheet.
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