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1016FORM CMS1728943290 (Cont.) This report is required by law (42 USC 1395g; 42 CFR 413.20(b)). Failure to report can result in all interim payments made since the beginning of the cost reporting

How to fill out form cms-1728-94 - halmanac

How to fill out form cms-1728-94

1. To fill out form CMS-1728-94, follow these steps: 1. Begin by providing your organization's name, address, and tax identification number in the designated fields.
2. Indicate whether your organization is classified as a hospital, home health agency, nursing facility, or other type of healthcare entity.
3. Provide the fiscal year for which you are submitting the form.
4. Proceed to the financial information section where you will need to detail various operating and non-operating revenues and expenses.
5. Include details about any non-patient care activities or any unusual financial events that may have occurred during the fiscal year.
6. Attach any required supporting documentation, such as audited financial statements or cost reports.
7. Review the completed form for accuracy and completeness before submitting it to the appropriate regulatory agency or organization.

Who needs form cms-1728-94?

1. Form CMS-1728-94 is required by healthcare organizations that are seeking to report their financial information to the appropriate regulatory agencies or organizations.
2. This form is typically used by hospitals, home health agencies, nursing facilities, and other healthcare entities.
3. It allows these organizations to provide detailed information about their financial performance during a specific fiscal year.

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