Get the free Provider CCN: 180104 - hfs illinois

Health Financial Systems WESTERN BAPTIST HOSPITAL This report is required by law (42 USC 1395g; 42 CFR 413.20(b)). Falure to report can result payments made since the beginning of the cost reporting period being deemed overpayments (42 HOSPITAL AND HOSPITAL HEALTH CARE COMPLEX COST REPORT CERTIFICATION Provider CCN: 180104 AND SETTLEMENT SUMMARYIn Lieu of Form CMS255210 in all interim FORM APPROVED USC 1395g). OMB NO. 09380050 Period: Worksheet S From 09/01/2011 Parts IIII To 08/31/2012...

How to fill out provider ccn 180104

How to fill out provider ccn 180104

1. Gather necessary documentation and information required for the CCN 180104 form.
2. Start filling out the form with the basic provider information, including name, address, and contact details.
3. Enter the tax identification number (TIN) and National Provider Identifier (NPI) where applicable.
4. Provide details about the services offered, including specific codes and descriptions.
5. Include any relevant certifications or licenses that support the provider's qualifications.
6. Review the completed form for accuracy and ensure all sections are filled out.
7. Submit the form by the designated method indicated in the instructions.

Who needs provider ccn 180104?

1. Healthcare providers seeking to enroll or update their information in a Medicare program.
2. Facilities or organizations that require a provider number to bill Medicare for services.

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What is provider ccn 180104?

Provider CCN 180104 is a unique identifier assigned to a healthcare provider in the U.S. Medicare system, used to classify and verify the identity of the provider.

Who is required to file provider ccn 180104?

Healthcare providers that participate in Medicare services must file provider CCN 180104 to ensure proper identification and claim processing.

How to fill out provider ccn 180104?

To fill out provider CCN 180104, providers must obtain the necessary forms from Medicare, provide accurate identification information, including their personal and business details, and follow the specific guidelines outlined in the instructions.

What is the purpose of provider ccn 180104?

The purpose of provider CCN 180104 is to facilitate the claims process for Medicare, ensuring that services provided by healthcare facilities are accurately billed and reimbursed.

What information must be reported on provider ccn 180104?

Information that must be reported on provider CCN 180104 includes the provider's name, address, tax identification number, type of provider, and other relevant details required by Medicare.