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Long Term Care Hospital (LATCH) Site Neutral Dispute Form
FAX with supporting documentation to: 18774395479
Select one
option belowReason for Site Neutral Payment
Immediately preceding inpatient stay
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What is long term care hospital?
A long term care hospital is a type of medical facility that specializes in extended care for patients who require a longer period of hospitalization.
Who is required to file long term care hospital?
Long term care hospitals are typically required to file by the healthcare facility or organization that operates the hospital.
How to fill out long term care hospital?
Long term care hospitals can be filled out electronically through the appropriate government agency's website or by mailing in a paper form.
What is the purpose of long term care hospital?
The purpose of a long term care hospital is to provide specialized and extended care to patients who require longer hospital stays for their medical conditions.
What information must be reported on long term care hospital?
Information such as patient demographics, medical diagnoses, treatments received, and length of stay must be reported on long term care hospitals.
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