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Number Requirement Responsibility A/B MAC DME Shared-System Maintainers Other A B HHH FISS MCS VMS CWF MAC X 9953. However if the change involves data not captured on the CMS-855I the change must be made on the applicable CMS form i.e. CMS-855B CMS-855R. 2. The authorized or delegated official who signs section 6 of the Form CMS-855R must be currently on file with 855B Form CMS-855I and Form CMS-855R - the person must be listed on the CMS-855A or CMS-855B as an authorized or delegated...
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Open change request form 9953.
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Start by filling out the basic information such as the requester's name, contact details, and the date.
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Specify the reason for the change request in a clear and concise manner.
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Provide a detailed description of the requested change, including any relevant background information.
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Identify the potential impact of the change and any associated risks or benefits.
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Change request 9953 is needed by individuals or organizations who want to propose a modification or alteration to a particular process, procedure, system, or product.
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It can be used by employees, customers, or stakeholders who have identified a need for change and want to formally request it.
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Change request 9953 is a valuable tool for initiating a change management process and ensuring proper documentation and evaluation of proposed changes.
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Change request 9953 is a formal document requesting a change to a project, process, or system.
The project manager or the person overseeing the project is typically required to file change request 9953.
To fill out change request 9953, one must provide detailed information about the proposed change, its impact, and justification.
The purpose of change request 9953 is to document and track changes to ensure they are properly reviewed and implemented.
Information such as the reason for the change, proposed solution, impact analysis, and implementation plan must be reported on change request 9953.
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