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PRINTED: 02/04/2020 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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Clearly state the purpose of the follow up and reference any previous communication if applicable.
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Provide a brief summary of the main points discussed or issues raised in the original correspondence.
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A paper follow up is a formal written response or documentation submitted to provide additional information or clarification regarding a previous filing or request.
Individuals or entities that have previously submitted a form or application and need to provide additional information, corrections, or responses to inquiries are required to file a paper follow up.
To fill out a paper follow up, ensure to provide your identifying information, clearly state the context of the follow up, attach any necessary documentation, and answer all relevant questions thoroughly.
The purpose of a paper follow up is to address queries, provide clarification, or submit additional information that supports the original application or filing.
Information that must be reported includes your personal or business identification details, the reference number of the original submission, a clear explanation of the follow up reason, and any relevant documentation.
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