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Get the free ISDH Hospital Service Report State Form 49476 (R /7-02) IC 16-21-6 - In

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ISDN Hospital Service Report State Form 49476 (R /702) IC 16216Status: Finalized I. Hospital Information Hospital ST VINCENT RANDOLPH HOSPITAL INC Name: Provider #: 151301 City: Winchester County:
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Obtain the ISDH hospital service report form.
02
Fill in the required information such as patient name, date of service, hospital name, and services provided.
03
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04
Make sure all information is accurate and complete.
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Submit the completed form to the appropriate department or agency.

Who needs isdh hospital service report?

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The ISDH Hospital Service Report is a report that hospitals in Indiana are required to submit to the Indiana State Department of Health (ISDH) detailing the services provided by the hospital.
All hospitals in Indiana are required to file the ISDH Hospital Service Report.
The ISDH Hospital Service Report can be filled out electronically on the ISDH website or submitted via mail with the required information.
The purpose of the ISDH Hospital Service Report is to collect data on the services provided by hospitals in Indiana for the purpose of monitoring and improving healthcare quality.
The ISDH Hospital Service Report typically requires information on patient demographics, types of services provided, hospital admissions, and other relevant healthcare data.
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