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Health Financial Systems
ST. JOSEPHS REG MED CENTER PLYMOUTH
In Lieu of Form CMS255210
This report is required by law (42 USC 1395g; 42 CFR 413.20(b)). Failure to report can result in all interim
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Healthcare providers and facilities who participate in the Medicare program
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What is 07-23 form cms-224-14 4490?
The 07-23 form CMS-224-14 4490 is a specific form used by healthcare providers to apply for Medicare enrollment as a provider of services or supplies.
Who is required to file 07-23 form cms-224-14 4490?
Healthcare providers and suppliers who wish to enroll in the Medicare program must file the 07-23 form CMS-224-14 4490.
How to fill out 07-23 form cms-224-14 4490?
To fill out the 07-23 form CMS-224-14 4490, providers need to provide their basic business information, types of services offered, and other relevant details as required by the form's instructions.
What is the purpose of 07-23 form cms-224-14 4490?
The purpose of the 07-23 form CMS-224-14 4490 is to formally enroll and provide necessary information about the healthcare provider or supplier to the Medicare program.
What information must be reported on 07-23 form cms-224-14 4490?
The form requires information such as provider identification details, service location, types of services provided, and billing information.
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