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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:02/01/2016FORM
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Unsubstantiated due to lack refers to claims or assertions that cannot be supported or validated because there is insufficient evidence or information provided.
Individuals or organizations that have claims or deductions without adequate supporting documentation are required to file unsubstantiated due to lack.
To fill out unsubstantiated due to lack, provide a clear description of the claimed item, specify the lack of supporting evidence, and submit any relevant details that may help clarify the situation.
The purpose of unsubstantiated due to lack is to formally report and document claims that cannot be verified, allowing for transparency and record-keeping for potential future review.
Information that must be reported includes the nature of the claim, reasons for the lack of evidence, any attempts made to gather supporting documentation, and relevant dates.
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