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Page 22 of 30 ATTACHMENT A to APM A5.504University of Hawaii`I Conflict of Interest Disclosure Form This form must be completed by all employees (defined in Section II. K. of APM A5.504) as required
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To fill out Attachment A to APM, follow these steps:
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Start by downloading the Attachment A to APM form from the official website of the relevant authority.
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Attachment A to APM is a supplementary form that provides specific information required by the Alternative Payment Model (APM) documentation. It includes details necessary for the proper assessment of performance metrics and payment adjustments.
Providers participating in an Alternative Payment Model are required to file Attachment A to APM to ensure compliance with APM requirements and to report relevant data.
To fill out Attachment A to APM, providers should complete the required fields with accurate information regarding their APM participation, including metrics and performance data as specified in the form instructions.
The purpose of Attachment A to APM is to collect necessary data from providers participating in APMs to evaluate their performance, compliance with the model, and to facilitate appropriate payment adjustments.
The information reported on Attachment A to APM typically includes performance metrics, patient care data, financial information related to the APM, and other required documentation related to service delivery.
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