Get the free Form DHHS 224-A: Hospital Registration

Hospital Application for Registration (Form HHS 224A) NC Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Abuse Services Drug Control Unit

How to fill out form dhhs 224-a hospital

How to fill out form dhhs 224-a hospital

1. Begin by obtaining a copy of form DHHS 224-A hospital from the appropriate department or agency.
2. Start filling out the form by providing the required identification information, such as your name, date of birth, and social security number.
3. Proceed to the sections requesting specific details about the hospital where the form is being submitted, including the hospital's name, address, and license number.
4. Complete the sections related to the patient's information, such as their name, date of birth, gender, and medical record number.
5. Fill in the details regarding the hospitalization, including the dates of admission and discharge, reason for hospitalization, and the name of the attending physician.
6. Answer any additional questions or provide any requested information, such as the insurance coverage details and responsible party's information.
7. Review the form to ensure all fields have been filled correctly and completely.
8. Sign and date the form.
9. Submit the form DHHS 224-A hospital to the designated department or agency, according to the provided instructions.

Who needs form dhhs 224-a hospital?

1. Form DHHS 224-A hospital is typically needed by hospitals or healthcare facilities that are required to report patient data and hospitalization statistics to the appropriate department or agency. This form helps in maintaining accurate and up-to-date records regarding hospitalizations and related information.

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What is form dhhs 224-a hospital?

Form DHHS 224-A Hospital is a report form used by hospitals to provide information about their services, finances, and other relevant data to the Department of Health and Human Services.

Who is required to file form dhhs 224-a hospital?

Hospitals are required to file form DHHS 224-A Hospital.

How to fill out form dhhs 224-a hospital?

Form DHHS 224-A Hospital can be filled out by providing accurate and up-to-date information on the services, finances, and other data of the hospital.

What is the purpose of form dhhs 224-a hospital?

The purpose of form DHHS 224-A Hospital is to collect information from hospitals to monitor their performance, ensure compliance with regulations, and improve healthcare quality.

What information must be reported on form dhhs 224-a hospital?

Information such as services provided, financial data, staffing levels, and quality metrics must be reported on form DHHS 224-A Hospital.