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Health Financial Systems IU HEALTH GOSH EN HOSPITAL In Lieu of Form CMS255210 This report is required by law (42 USC 1395g; 42 CFR 413.20(b)). Failure to report can result in all interim FORM APPROVED
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Indiana University Health Goshen is a regional health system that provides a full range of healthcare services to the community.
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All individuals or entities who receive healthcare services from Indiana University Health Goshen are required to file.
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The purpose of Indiana University Health Goshen is to track and report healthcare services provided to the community.
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Information such as the type of healthcare services, dates of service, and any associated costs must be reported on Indiana University Health Goshen.
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