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APPENDIX R A. Required Data Elements For EnrollmentMassHealth RequirementSubmitted by Mobile submitter IMS Health PID/SL of MCO(describe t_pr_identifier) ALT_ID_PROVIDEREnrolling Providers NPI(describe
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To fill out Appendix R on MassGov:
02
Visit the MassGov website and navigate to the page for Appendix R.
03
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04
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Appendix R on MassGov may be needed by individuals or organizations who are required to provide additional information, documentation, or disclosures as part of a specific process or application.
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The specific requirements for needing Appendix R may vary depending on the context in which it is referenced.
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It is recommended to review the instructions and guidelines provided by MassGov to determine if Appendix R is necessary for your particular situation.
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What is appendix r massgov?
Appendix R is a form used by Massachusetts employers to report their employer paid health care costs.
Who is required to file appendix r massgov?
All Massachusetts employers who provide health insurance to their employees are required to file appendix R.
How to fill out appendix r massgov?
Employers must enter information about the health insurance coverage provided to their employees in the designated sections of the form.
What is the purpose of appendix r massgov?
The purpose of the form is to collect data on employer paid health care costs in Massachusetts.
What information must be reported on appendix r massgov?
Employers must report the total health care costs paid on behalf of their employees, as well as information about the insurance plans offered.
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