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This form is used to calculate the Medicare reimbursement settlement for various health care facilities and services, including inpatient rehabilitation facilities (IRF), long-term care hospitals
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How to fill out form cms-2552-96
How to fill out FORM CMS-2552-96
01
Obtain FORM CMS-2552-96 from the CMS website or through your Medicare Administrative Contractor (MAC).
02
Start by filling out the provider identification section, including the name, address, and NPI of your facility.
03
Complete the Medicare cost report section, making sure to include all applicable financial data from the reporting period.
04
Fill in the adjustments and allocations required for your specific service categories.
05
Ensure that you report the number of patients and days of service accurately.
06
Review the applicable instructions for any specific requirements related to your facility type.
07
Sign and date the form certifying the information provided is accurate.
08
Submit the completed form by the due date to the appropriate MAC.
Who needs FORM CMS-2552-96?
01
Any healthcare facility that participates in the Medicare program and provides services to Medicare beneficiaries needs FORM CMS-2552-96.
02
This includes hospitals and skilled nursing facilities seeking reimbursement for Medicare services provided.
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People Also Ask about
Can I submit form CMS 1763 online?
The CMS-1450 form (aka UB-04 at present) can be used by an institutional provider to bill a Medicare fiscal intermediary (FI) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of claims.
Can I fax CMS 1763?
Fill out Request for Termination of Premium Hospital Insurance of Supplementary Medical Insurance (Form CMS-1763) (PDF) and fax or mail it to your local Social Security office.
Can I submit my Medicare Part B application online?
You can complete your Medicare Part B Enrollment online. You will electronically sign the online application, so you will need to provide an email address.
Can I check my Medicare Part B status online?
Log into (or create) your secure Medicare account. You'll usually be able to see a claim within 24 hours after Medicare processes it. A notice you get after the doctor, other health care provider, or supplier files a claim for Part A or Part B services in Original Medicare.
What is a CMS form?
Medicare Part 2, Provider Cost Reporting Forms and Instructions, Chapter 40, Form CMS-2552-10. This transmittal updates Chapter 40, Hospital and Hospital Health Care Complex Cost Report (Form CMS-2552-10), by clarifying and revising the existing instructions and by revising existing edits. Effective dates vary.
Where do I send my CMS 1763 form?
Send your completed and signed application to your local Social Security office. If you have questions, call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778.
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What is FORM CMS-2552-96?
FORM CMS-2552-96 is a cost report used by Medicare-certified hospitals to report their costs and submit claims for reimbursement.
Who is required to file FORM CMS-2552-96?
Medicare-certified hospitals that provide inpatient care are required to file FORM CMS-2552-96.
How to fill out FORM CMS-2552-96?
To fill out FORM CMS-2552-96, hospitals must gather financial information, follow the instructions provided by CMS, and accurately input costs associated with patient care.
What is the purpose of FORM CMS-2552-96?
The purpose of FORM CMS-2552-96 is to calculate Medicare reimbursement for inpatient hospital services and to ensure compliance with federal regulations.
What information must be reported on FORM CMS-2552-96?
The information that must be reported on FORM CMS-2552-96 includes total expenses, costs allocated to patient care, revenue information, and specific adjustments as required by CMS guidelines.
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