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FORM APPROVED OMB NO 09381269
Expiration 2/28/2022HOSPICE INFORMATION FOR MEDICARE PART D PLANS
SECTION I HOSPICE INFORMATION TO OVERRIDE AN HOSPICE A3 REJECT OR TO UPDATE HOSPICE
STATUS
A. Purpose
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What is omb 0938 1269?
OMB 0938-1269 refers to a specific information collection request approved by the Office of Management and Budget (OMB) related to healthcare and Medicare services.
Who is required to file omb 0938 1269?
Entities involved in providing Medicare services or those required to report information under the Medicare program must file OMB 0938-1269.
How to fill out omb 0938 1269?
Filling out OMB 0938-1269 typically involves providing specific information about healthcare services, patients, and compliance with Medicare regulations as detailed in the form instructions.
What is the purpose of omb 0938 1269?
The purpose of OMB 0938-1269 is to collect necessary data to ensure compliance with Medicare requirements and to facilitate proper service delivery and reimbursement.
What information must be reported on omb 0938 1269?
OMB 0938-1269 requires reporting of data related to healthcare utilization, patient information, services provided, and compliance with Medicare standards.
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