CMS Change Request User Guide. Required April 1, Consolo Services CMS Change Request 8358 User Guide P a g e 1

Size: px
Start display at page:

Download "CMS Change Request User Guide. Required April 1, Consolo Services CMS Change Request 8358 User Guide P a g e 1"

Transcription

1 CMS Change Request 8358 User Guide Required April 1, 2014 Cnsl Services CMS Change Request 8358 User Guide P a g e 1

2 CMS Change Request 8358 Required April 1, 2014 User Guide Overview: CMS Change Request (CR) 8358 requires Claims t include mre details relating t the fllwing areas f prviding Hspice Care: Medicatin Fill Data Injectable Prescriptin Drugs Nn-injectable Prescriptin Drugs Infusin Pumps and Infusin Drugs Pst Mrtem Visits Visits Cmpleted n Date f Death fr the fllwing Types f Hspice Emplyees Nurses Hspice Aides Scial Wrkers Therapists Facility Details Natinal Prvider Identifier (NPI) and 9 digit Zip Cde f the Nursing Facility, Hspital, r Hspice Inpatient Facility where patient receives services General inpatient Care (GIP) Visit Details Line item visit data fr hspice staff prvided under general inpatient care (GIP) in skilled nursing facilities (SNF) r hspitals This User Guide defines the prcesses within Cnsl t meet the specificatin f CMS Change Request Please refer t the Help Menu / Training Vides fr further Training pprtunities. Cnsl Services CMS Change Request 8358 User Guide P a g e 2

3 CMS Change Request 8358 Medicatins General Infrmatin Cnsl Services CMS Change Request 8358 User Guide P a g e 3

4 Medicatins Ppulating Claims with Details Relating t CMS Change Request 8358 The Cnsl Services Team has established slutins fr meeting the updated reprting requirements set frth by CMS in Change Request CMS is requesting Hspice prviders display the fllwing details n claims prcessed fr Hspice Medicare Part A Beneficiaries: Details frm CMS: Reprt Injectable Drugs Line-item bill per Medicatin Fill Revenue cde = 0636 HCPCS cde fr drug - See list at 4.pdf Units = amunt filled based n HCPCS descriptin Example: HCPCS Q1234 is fr 100 mg, and fill was 200 mg, reprt 2 units Charges Service Date Example frm CMS: Reprt Nn-Injectable Drugs Line-item bill per Medicatin Fill Revenue cde = 0250 Natinal Drug Cde (NDC) List available at: Quantity - NDC qualifier is quantity f drug filled, reprted as unit f measure Charges Service Date NDC is reprted - 11 digit NDC (n hyphens) Cnsl Services CMS Change Request 8358 User Guide P a g e 4

5 Reprt Nn-Injectable Drugs (Cntinued) Unit f Measurement Qualifier F2= Internatinal Unit GR = Gram ME- Milligram ML = Milliliter UN = Unit Reprt Infusin Pumps and Infusin Drugs Line-item bill per Pump Order Line-item bill per Medicatin Refill Revenue Cdes = 0291 (pump, rented); 0292 (pump, new); 0293 (pump, used); and 0294 (drugs) HCPCS = apprpriate cde See list f HCPCS fr drugs at: 4.pdf Units Charges Service date Example frm CMS: Cnsl Services CMS Change Request 8358 User Guide P a g e 5

6 Cnsl Methds fr Ppulating Claims with Medicatin Details Cnsl has develped three methds t btain the Medicatin Fill Data frm pharmacies and add it t Claims t meet the specificatins defined by CMS in Change Request The three methds are summarized belw and the cmplete prcesses are defined in the pages that fllw: Methd I - Autmated Claims Integratin with Pharmacy Benefit Managers Cnsl is wrking with a number f Pharmacy Benefit Managers (PBMs) t autmate the Medicatin Fill data int Cnsl. The PBMs are able t send data in a specific frmat via secure transprt, including the Patient ID, directly t Cnsl s Integratin Netwrk. Ntify Integratins@cnslservices.cm t begin the implementatin with yur PBM. Methd II - CSV File Uplad Capability Cnsl has prvided a CSV file frmat that can be shared with lcal pharmacies. The pharmacies can prvide a file in the required frmat that may be upladed int Cnsl. Cnsl has created a dcument with file specificatins that may be distributed t lcal pharmacies s hspices may wrk with them with the gal f btaining medicatin details in the prper frmat fr uplad. Please find the Retail Pharmacy CSV Uplad dcument and a Sample CSV File in the Help Menu / Release Ntes Area. Methd III - Data Entry Cnsl is ffering a data entry screen within the system where Medicatin Fill Data may be manually entered. This methd may be used fr medicatin details frm lcal pharmacies that will nly prvide the infrmatin in paper frmat. Identifying Patients t Pharmacies and Pharmacy Benefit Prviders (PBMs) Patient Identificatin Number The Patient Identificatin Number data is unique and prperly identifies Patients within Cnsl. This number is critical t prvide t Pharmacies relating t ppulating Medicatins n Claims, as required by CMS CR The Patient Identificatin Number is the Unique Number listed in the Patient URL r Web Address that als lists n: Patient Search Filter Faxed Dcuments Patient Hme Page Header by the Patient Name Mre Buttn n the Patient Hme Page Face Sheets Active Patient Summary Medicatin Reprt Nte: It is critical t identify Patients t Pharmacies and PBMs using the Patient Identificatin Number in rder t prperly assciate Medicatins t Cnsl Patients. Cnsl Services CMS Change Request 8358 User Guide P a g e 6

7 Examples f the Patient Identificatin Number (the Number frm the URL): Patient Hme Page (After Patient Name) Mre Buttn Details (frm the Patient Hme Page) Cnsl Services CMS Change Request 8358 User Guide P a g e 7

8 Search Screen Filter Active Patient Summary Reprt Cnsl Services CMS Change Request 8358 User Guide P a g e 8

9 Security - Rle Changes Medicatin Fill A new Sectin appears in the Rles Screen fr Medicatin Fills. These ptins handle the new functinality relating t CMS CR-8358 allwing the Hspice t track Medicatin details and csts assciated with each patient. Cnsl Services CMS Change Request 8358 User Guide P a g e 9

10 CMS Change Request 8358 Ppulating Medicatin Data n Claims Methd I - Autmated Integratin With Pharmacy Benefit Managers Cnsl Services CMS Change Request 8358 User Guide P a g e 10

11 Medicatins Ppulating Claims with Details Relating t CMS Change Request 8358 Methd I - Autmated Claims Integratin with Pharmacy Benefit Managers (PBMs) Cnsl is wrking with a number f Pharmacy Benefit Managers (PBMs) t autmate the Medicatin Fill data int Cnsl. The PBMs are able t send the data in a predetermined frmat via secure transprt, including the Patient ID, directly t Cnsl s Integratin Netwrk. If a Hspice PBM interfaces directly with Cnsl, the Medicatin Details will be autmatically ppulated in Cnsl. It will be necessary t verify there are n PBM Imprt Exceptins by ding the fllwing: G t the Patient Menu Select the Medicatin Fill Recrds G t Related Links Select View PBM Imprt Exceptins Cnsl Services CMS Change Request 8358 User Guide P a g e 11

12 View the Medicatin Exceptin t Evaluate and Crrect Issues Click Enter Medicatin Fill t Open an Edit Screen t Crrect Issues Cnsl Services CMS Change Request 8358 User Guide P a g e 12

13 Crrect Issues and Save Nte: Exceptins shuld be reviewed prir t prcessing claims and may nt be deleted Cnsl Services CMS Change Request 8358 User Guide P a g e 13

14 CMS Change Request 8358 Ppulating Medicatin Data n Claims Methd II - CSV Uplad Capability Cnsl Services CMS Change Request 8358 User Guide P a g e 14

15 Medicatins Ppulating Claims with Details Relating t CMS Change Request 8358 Methd II - CSV File Uplad Capability Cnsl has created a dcument with file frmat specificatins that may be distributed t lcal pharmacies s hspices may wrk with them with the gal f btaining medicatin fill details in the prper frmat fr uplad. Please find the Retail Pharmacy CSV Uplad dcument and a Sample CSV File in the Help Menu / Release Ntes Area. Sample CSV (Clumn sizes are reduced in this sample) Nte: Retail Pharmacies may create a CSV file in the frmat abve and it may be imprted int Cnsl r a Hspice may type the data nt the CSV File and imprt it int the system Cnsl Services CMS Change Request 8358 User Guide P a g e 15

16 CSV Files Created Manually Pages describe hw t dwnlad the CSV File Template s a Hspice may manually enter medicatin fill data and then uplad it int Cnsl. A hspice wuld use this methd if a Pharmacy des nt prvide the data in the prper frmat. CSV Files Created by a Pharmacy Page 20 describes hw t Uplad a CSV File frm a CSV file created by a Pharmacy (and a file that a Hspice Manually Entered). T Dwnlad a cpy f the CSV File Template frm Cnsl and Enter Data fr Uplad: G T the Patient Menu Select Medicatin Fill Recrd G t Related Links Select Imprt frm CSV Cnsl Services CMS Change Request 8358 User Guide P a g e 16

17 Select Display Field Infrmatin t Learn Mre abut the Fields in the CSV File Descriptins f Fields n the CSV Imprt File Display n the Screen Cnsl Services CMS Change Request 8358 User Guide P a g e 17

18 Select Dwnlad Template Sample CSV Template Nte: Patient Names and ID Numbers will display n the CSV file fr all active Patients within the last 45 days (names may be deleted as needed and rws can be added fr multiple medicatin fills per patient) Cnsl Services CMS Change Request 8358 User Guide P a g e 18

19 Enter Medicatin Data Ntes: NDC Cdes cannt cntain Dashes and must be11 Digits. Shrter numbers will be pre-filled with zeres. All drugs must cntain the NDC. Injectable and infusin drugs als have a HCPCS Cde, but if the HCPCS field is left blank, Cnsl will fill the HCPCS field frm the NDC data. Infusin Pumps d nt have an NDC and require a HCPCS cde. Cmpunds shuld be listed as separate line items but shuld have the same Rx Number. Only Prescriptin Drugs (Rx=Y) display n Claims. Save File The File Must be Saved as a CSV (Cmma Delimited) File Nte: A CSV File may be saved in Excel Cnsl Services CMS Change Request 8358 User Guide P a g e 19

20 Uplading a CSV File frm a Pharmacy r a CSV a Hspice Manually Entered Select Chse File Select File Select Uplad Cnsl Services CMS Change Request 8358 User Guide P a g e 20

21 Nte: Errrs appear n the screen in Red, the entire spreadsheet will need t be upladed again nce errrs are crrected, (nne f the data will imprt) Crrect the CSV File and Re-Uplad The Screen belw shws a successful imprt Nte: Recently Entered r imprted Medicatin Fills List n the Page Cnsl Services CMS Change Request 8358 User Guide P a g e 21

22 CMS Change Request 8358 Ppulating Medicatin Data n Claims Methd III - Data Entry Cnsl Services CMS Change Request 8358 User Guide P a g e 22

23 Medicatins Ppulating Claims with Details Relating t CMS Change Request 8358 Methd III - Data Entry Medicatin Fills may be Created frm a Patient Hme Page r frm the Patient Menu Enter Data frm the Patient Menu if entering Medicatins fr several Patients G T the Patient Menu Select Medicatin Fill Recrds T Enter Data frm a Patient Hme Page G t a Patient Hme Page Open the Medicatin Area Select Medicatin Fill Recrd The page will pen t the Medicatin Fill Summary Page Select Create a New Medicatin Fill Cnsl Services CMS Change Request 8358 User Guide P a g e 23

24 Cmplete Data Entry Fields Create and Cntinue Adding Medicatin Fills Ntes: The Patient Name Field des nt appear if accessing frm the Hme Page All Drugs must cntain the NDC. Type the medicatin name r NDC in the Medicatin Lk-up sectin t find the crrect drug. Injectable and Infusin drugs als have a HCPCS Cde, but if the HCPCS field is left blank, Cnsl will fill the HCPCS field frm the NDC data. Fr Infusin Pumps use the HCPCS Cde Lk-up instead f the Medicatin Lk-up. Quantity wuld be the number f pills, patches, vials, etc. D nt enter dsages here. Only Prescriptin Drugs display n Claims. Un-check the Prescriptin checkbx fr OTC drugs. If a Pharmacy r DME Supplier cannt be fund in the Lk-up, g t the Services menu and add it. Individual ingredients f cmpunds shuld be entered as separate drugs and must have the same Prescriptin Number. Cnsl Services CMS Change Request 8358 User Guide P a g e 24

25 Select Medicatin Fill Recrds (frm the Breadcrumbs) t Return t the Summary Page Summary Page Hand Keyed and CSV Upladed Medicatin Fills may be Edited frm this page Nte: Medicatins will flw t the Claim autmatically The Hspice Claims Team will nt need t d anything t ppulate Medicatin Details during the Claims Prcess Cnsl Services CMS Change Request 8358 User Guide P a g e 25

26 CMS Change Request 8358 Medicatins Preparing fr Claims Prcessing Cnsl Services CMS Change Request 8358 User Guide P a g e 26

27 Cmpare Against Medicatin Recrds Cmpare Medicatins that have been filled are in the Medicatin Recrd: G T the Medicatin Fill Screen Select Related Links Select Cmpare Against Medicatin Recrds Verificatin that Medicatins Filled are in the Medicatin Recrd Click Cpy t Med t Add Medicatin t the Medicatin Recrd Add Medicatin Details fr the Medicatin Recrd Cnsl Services CMS Change Request 8358 User Guide P a g e 27

28 Reversing an Entry (Required if a change is needed t Hand Keyed r CSV Upladed Entries if a Claim has been Prcessed) G t a Patient Hme Page Open the Medicatin Area Select Medicatin Fill Recrd The page will pen t the Medicatin Fill Summary Page Click Icn t View Medicatin Fill Recrd Cnsl Services CMS Change Request 8358 User Guide P a g e 28

29 G t Related Links Select Create Reversal Select Yes Create the Reversal Cnsl Services CMS Change Request 8358 User Guide P a g e 29

30 Sample f a Reversal Claim Sample Details Regarding Medicatin Fill Recrds: Interfaced Medicatin Fill Recrds may nt be deleted, but may be edited if there is an exceptin t be crrected. Imprted Medicatin Fill Recrds may be edited, deleted, and reversed. Hand-keyed Medicatin Fill Recrds may be edited, deleted, and reversed. Medicatin Fills f any type may nt be deleted r edited if assciated t a Claim. Incrrect Medicatin Fills must be reversed and a crrect Fill can then be entered. Cnsl Services CMS Change Request 8358 User Guide P a g e 30

31 CMS Change Request 8358 Facility and GIP Visit Details fr Claims Cnsl Services CMS Change Request 8358 User Guide P a g e 31

32 Facility and GIP Visit Details Ppulating n Claims Relating t CMS Change Release 8358 GIP Visit Details CMS Change Request 8358 requires that when the site f service is a Skilled Nursing Facility, Hspital, Lng Term Care Hspital r Inpatient Psychiatric Facility, visits are reprted by the number f units fr all fur levels f care including General Inpatient Level f Care. The changes will be visible n the claims and will nt impact charting. Details frm CMS: Claim Line item Reprting f GIP Visits in SNF (Q5004) r Hspital (Q5005, Q5007, Q5008) Applies nly t visits prvided by hspice staff Visits by nn-hspice staff still nt reprted Each Visit is Reprted n a separate Revenue Cde Line Units reflect duratin f visit, 15-minute increments Visits under GIP in an inpatient hspice unit (Q5006) are still reprted weekly Sample frm CMS: Facility Details CMS Change Request 8358 requires a 9 Digit Zip Cde and Facility NPI fr all Medicare claims when the patient is in ne f the fllwing Facility Types and the NPI f the facility is different frm the Hspice NPI: Lng Term Care Nn-Skilled Nursing Facility Skilled Nursing Facility Hspital Lng Term Care Hspital Inpatient Psychiatric Facility Inpatient Hspice Facility Hmecare Hspice Facility Cnsl Services CMS Change Request 8358 User Guide P a g e 32

33 Details frm CMS: Required Reprting f Natinal Prvider Identifier (NPI) t identify Nursing Facility, Hspital, r Hspice Inpatient Facility Lcatin where Patient Receives Services Reprt name, address and NPI Claims withut NPI will be returned t prvider (RTP) If care prvided in mre than ne facility in a billing mnth, reprt NPI where Patient last treated Claims reprting Q5003, Q5004, Q5005, Q5007 r Q5008 withut NPI will be returned t prvider (RTP) Crrecting Claim Errrs in Cnsl Cnsl checks claims t verify the NPIs and 9 digit Zip Cdes are present. Claims display errr messages when the Facility NPI and 9 digit Zip Cdes are missing. T crrect errrs, please G t the Services Tab, Edit the Facility and d the fllwing: Missing Facility NPI Number Errr - Add the NPI Number Missing Facility 9 Digit Zip Cde Errr Add the 9 Digit Zip Cde, then d the fllwing: G t the Patient Hme Page Open the Change in Care Area Edit/Save the Care Level Change s that the new Zip Cde is displayed Repair the Claim and Send Nte: T prevent Medicare Claim Rejectins please ensure that the Facility Types defined abve cntain a nine Digit Zip Cde and an NPI. Prir t Creating Claims, Run the Active Patient Summary Reprt t verify Zip Cdes fr the Facility Types listed abve are 9 digits. Cnsl Services CMS Change Request 8358 User Guide P a g e 33

34 Claim Sample Cnsl Services CMS Change Request 8358 User Guide P a g e 34

35 CMS Change Request 8358 Pst Mrtem Visit Details fr Claims Cnsl Services CMS Change Request 8358 User Guide P a g e 35

36 Pst-Mrtem Mdifier (PM) Ppulating n Claims Relating t CMS Change Release 8358 When charting fr the Date f Death, Visits which span the time f death shuld be entered as tw separate visits s they may be reprted separately n claims. Details frm CMS: Reprt Visits that ccur after Death and n Date f Death Includes hspice-emplyed nurses, aides, scial wrkers, and therapists Regardless f level f care, r site f service Billing requirements include: Revenue cde HCPCS cde Mdifier PM Units (15-minute increments) Charges Service date Visits subsequent t date f death are nt reprted Sample frm CMS Cnsl Services CMS Change Request 8358 User Guide P a g e 36

37 Example f Pst Mrtem Prcess within Cnsl Creating Tw Visits: Discharge Due t Death is 2/05/ Visit starts at 0600 and ends at 1200 Enter the Date and Time f Death in the Change in Care Screen Visit #1 - Enter ne visit frm 0600 t 0759 Cnsl Services CMS Change Request 8358 User Guide P a g e 37

38 Visit #2 - Enter the secnd visit frm 0800 t 1200 (Visit must be n Date f Death, beginning at Time f Death r after t be classified as Pst Mrtem n the Claim) Clinical Chart Summary Screen The first visit will nt be labeled as Pst-Mrtem, but the secnd ne will be classified as Pst Mrtem n the Claim. T determine which visits are labeled as Pst-Mrtem n the claim, the system will cmpare the Time In f the visit t the Effective Date/Time f the Discharge Due t Death Change in Care Entry. Ntes: The Time f Death displayed inside the Discharge Tab f the Care Level Change Screen is nt used fr Pst Mrtem Visits If the visit is n r after the Discharge Due t Death Date and Time, the visit will be labeled with a PM mdifier n the claim If the visit starts prir t the Discharge Due t Death Date and Time, it will lk like any ther visit n the claim. Pst Mrtem Visits that pass midnight n the Date f Death shuld have a time ut f 11:59 and an additinal entry shuld be created fr the Day after Death, this visit will nt be included n the claim Cnsl Services CMS Change Request 8358 User Guide P a g e 38

39 Pst Mrtem Reprting Medicare Visit Summary Reprt The Medicare Visit Summary Reprt will identify which visits are Pst Mrtem and this reprt may be used t verify Pst Mrtem Visits are entered accurately prir t prcessing claims. Pst Mrtem Visits may be identified frm the Patient Clinical Charting Summary Page: Filter fr Pst Mrtem = Yes Pst Mrtem Symbl Claim Example: Cnsl Services CMS Change Request 8358 User Guide P a g e 39

Work Instruction Patient Visits

Work Instruction Patient Visits Wrk Instructin Patient Visits THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO Wrk Instructin Patient Visits Vels - eresearch Versin 9.2 Versin: 2.0, 04/30/2015 Wrk Instructin Patient Visits

More information

Department of Teacher Education Tentative Admission

Department of Teacher Education Tentative Admission Department f Teacher Educatin Tentative Admissin Requirements Must have cmpleted a minimum f 60 cllege credit hurs Minimum GPA f 2.75 Minimum cmpsite scre (r super scre) f 20 n the ACT Cmplete the Missuri

More information

Patient Instructions for Home Medical Equipment

Patient Instructions for Home Medical Equipment Patient Instructins fr Hme Medical Equipment In rder fr ABC Health Care t cmplete the request fr yur prescribed hme medical equipment, we will need the fllwing dcumentatin requirements cmpleted in full

More information

Florida Department of Financial Services Florida Accountability Contract Tracking System (FACTS)

Florida Department of Financial Services Florida Accountability Contract Tracking System (FACTS) Flrida Department f Financial Services Flrida Accuntability Cntract Tracking System (FACTS) Agreement Agency FTP Batch Transmissin User Guide July 2014 Table f Cntents Intrductin:... 3 Agency Assumptins:...

More information

Down Payment Online Manual

Down Payment Online Manual Dwn Payment Online Manual Dwn Payment Online Manual Member cntacts may use this manual t help navigate Dwn Payment/Set Aside Prgram (DP) Online and perfrm the fllwing functins: 1. Lg int DP Online thrugh

More information

Scheduling and Registration (Specialty Hospital) Training Guide

Scheduling and Registration (Specialty Hospital) Training Guide Scheduling and Registratin (Specialty Hspital) Visin 4.3 (December 2012) Training Guide SurceMedical Learning Center f Excellence Last change made: January 2013 2013 Surce Medical Slutins, Inc. All Rights

More information

Frequently asked questions about health identifiers August 2015

Frequently asked questions about health identifiers August 2015 Frequently asked questins abut health identifiers August 2015 1 P a g e Questins abut individual health identifiers What is an individual health identifier r IHI? An individual health identifier r IHI

More information

Medicaid EHR Incentive Program Eligible Professionals

Medicaid EHR Incentive Program Eligible Professionals Medicaid EHR Incentive Prgram Eligible Prfessinals Payment Year 1 Adpt, Implement, Upgrade New Hampshire Department f Health and Human Services Office f Medicaid Business and Plicy First Year Attestatin

More information

Key Points for Approving Officers Regarding Electronic Filing

Key Points for Approving Officers Regarding Electronic Filing Key Pints fr Apprving Officers Regarding Electrnic Filing The Land Title Act allws a subdivisin plan t be prepared and submitted t the Land Title Office electrnically. T assist Apprving Officers (AO) with

More information

Patient Instructions for Home Medical Equipment

Patient Instructions for Home Medical Equipment Patient Instructins fr Hme Medical Equipment In rder fr ABC Health Care t cmplete the request fr yur prescribed hme medical equipment, we will need the fllwing dcumentatin requirements cmpleted in full

More information

April 2, Jennifer Kent Director California Department of Health Care Services 1501 Capitol Avenue Sacramento, CA 95814

April 2, Jennifer Kent Director California Department of Health Care Services 1501 Capitol Avenue Sacramento, CA 95814 Jennifer Kent Directr Califrnia Department f Health Care Services 1501 Capitl Avenue Sacrament, CA 95814 Subject: Draft All Plan Letter 18-XXX - Medicaid Drug Rebate Prgram Via e-mail: Jennifer.Kent@dhcs.ca.gv

More information

NOTE: The first appearance of terms in bold in the body of this document (except titles) are defined terms please refer to the Definitions section.

NOTE: The first appearance of terms in bold in the body of this document (except titles) are defined terms please refer to the Definitions section. TITLE MANAGEMENT OF PATIENT S OWN MEDICATIONS SCOPE Prvincial APPROVAL AUTHORITY Clinical Operatins Executive Cmmittee SPONSOR Prvincial Medicatin Management Cmmittee PARENT DOCUMENT TITLE, TYPE AND NUMBER

More information

LSU HEALTH SHREVEPORT NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION

LSU HEALTH SHREVEPORT NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION LSU HEALTH SHREVEPORT NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

More information

SECTION A: Patient s name: Last: First: MI: Date of birth: Phone number: Medical Record Number:

SECTION A: Patient s name: Last: First: MI: Date of birth: Phone number: Medical Record Number: Stanfrd Health Care (SHC) Stanfrd, CA 94305 Phne: 650-723-5721 HEALTH INFORMATION Page 1 f 6 AUTHORIZATION FOR USE OR DISCLOSURE OF PROTECTED HEALTH INFORMATION When yu cmplete and sign this frm, health

More information

WHAT IS CAL MEDICONNECT? Cal MediConnect is a health plan that combines all of the benefits you now get from Medicare and Medi-Cal into a single plan.

WHAT IS CAL MEDICONNECT? Cal MediConnect is a health plan that combines all of the benefits you now get from Medicare and Medi-Cal into a single plan. Last updated: 3/8/2016 5:25 PM DO YOU HAVE BOTH MEDICARE AND MEDI-CAL? Intrductin If s, yu may be eligible t jin a Cal MediCnnect health plan. WHAT IS CAL MEDICONNECT? Cal MediCnnect is a health plan that

More information

Denver Public Schools. Financial Services. Financial Services Manual. Grants

Denver Public Schools. Financial Services. Financial Services Manual. Grants Denver Public Schls Financial Services Financial Services Manual Grants Table f Cntents Grants... 3 Prcedures GRC Website... 3 Step by Step Guide... 4 Federal Grants... 7 Title I... 7 Title II... 8 Time

More information

The information and instructions below are for College of Business Administration [Departmental] Scholarships only.

The information and instructions below are for College of Business Administration [Departmental] Scholarships only. COLLEGE OF BUSINESS ADMINISTRATION DEPARTMENTAL SCHOLARSHIPS Cllege f Business Administratin departmental schlarships are available t business majrs in all cncentratins and are awarded t Business students

More information

Government Equalities Office Returners Fund

Government Equalities Office Returners Fund Gvernment Equalities Office Returners Fund Overview In the Spring Budget 2017, the Prime Minister cmmitted 5 millin t prmte returnships t the public and private sectrs, helping peple back int emplyment

More information

AMBULATORY SURGICAL CENTER (ASC) REGISTRATION INSTRUCTIONS for 2013

AMBULATORY SURGICAL CENTER (ASC) REGISTRATION INSTRUCTIONS for 2013 AMBULATORY SURGICAL CENTER (ASC) REGISTRATION INSTRUCTIONS fr 2013 Required Registratin f Ambulatry Surgical Centers (ASCs) Accrding t the Statewide Quality Reprting and Measurement System (SQRMS) f the

More information

AGENCY NAME - Crisis Stabilization Services

AGENCY NAME - Crisis Stabilization Services AGENCY NAME - Crisis Stabilizatin Services Prgram Statement Crisis stabilizatin services are prvided t children and adlescents ages 6-17 that have symptms and current presentatin that requires skilled

More information

Quincy University Grants Development & Management Guide

Quincy University Grants Development & Management Guide 1 Quincy University Grants Develpment & Management Guide Intrductin The Office f University Advancement versees the grants prcess at Quincy University and is yur resurce fr seeking funding frm any external

More information

Patient Portal Introduction and Overview

Patient Portal Introduction and Overview A health IT web slutin brught t yu by TSI Healthcare Patient Prtal Intrductin and Overview Cntrl Panel Audi Optins: This is a listen nly presentatin Audi by Phne Select Use Telephne Tl Dial the prvided

More information

Inpatient Rehab/LTLD Discharge Planning Practices Pre- and Post-Implementation Survey Results of TC LHIN Hospitals

Inpatient Rehab/LTLD Discharge Planning Practices Pre- and Post-Implementation Survey Results of TC LHIN Hospitals Inpatient Rehab/ Discharge Planning Practices Pre- and Results f TC LHIN Hspitals 1.0 BACKGROUND The Patient Access and Flw Cmmittee f the GTA Rehab Netwrk develped a new resurce, Discharge Planning Guidelines

More information

Vantel Pearls International, Inc. 46 Eastman Street, South Easton, MA Tel Compensation Plan.

Vantel Pearls International, Inc. 46 Eastman Street, South Easton, MA Tel Compensation Plan. Vantel Pearls Internatinal, Inc. 46 Eastman Street, Suth Eastn, MA 02035 www.vantelpearls.cm Tel. 508.698.2220 (March, 2016) Welcme t Vantel Pearls! This dcument prvides an verview f the incme, benefits,

More information

PRIVACY IMPACT ASSESSMENT (PIA) For the

PRIVACY IMPACT ASSESSMENT (PIA) For the PRIVACY IMPACT ASSESSMENT (PIA) Fr the Medical Bards Online Tracking System (MEDBOLTS) Department f the Navy - TMA DHP Funded System SECTION 1: IS A PIA REQUIRED? a. Will this Department f Defense (000)

More information

Growing Enterprise ERDF GRANT FUNDING PROCEDURES

Growing Enterprise ERDF GRANT FUNDING PROCEDURES Grwing Enterprise ERDF GRANT FUNDING PROCEDURES Stage Actin By Actins Ensure that the business and prject meet the eligibility criteria. Pre-Applicatin Stage 1 Pre-Applicatin Stage 2 NBV Enquiry Hub /

More information

Kiley Bybee-Francque, CJCP Associate Director Joint Office for Compliance

Kiley Bybee-Francque, CJCP Associate Director Joint Office for Compliance Kiley Bybee-Francque, CJCP Assciate Directr Jint Office fr Cmpliance 1 Abut Me 2 TJC Extensin Survey fr Child Health Specialty Clinics* Cmmissin n Accreditatin f Transprt Services (CAMTS) The American

More information

MIPS Improvement Activities Performance Category

MIPS Improvement Activities Performance Category MIPS Imprvement Activities Perfrmance Categry The Imprvement Activities cmpnent is ne f the fur Merit-Based Incentive Payment System (MIPS) perfrmance categries under which participating MIPS eligible

More information

H-1B PETITION EMPLOYEE QUESTIONNAIRE

H-1B PETITION EMPLOYEE QUESTIONNAIRE H-1B PETITION EMPLOYEE QUESTIONNAIRE SUPPORTING DOCUMENTS CHECKLIST Please email the fllwing dcuments t Office f Internatinal Prgrams as scanned clr cpies. Cmpleted H-1B Emplyee Questinnaire Please als

More information

Yolo County Homeless and Poverty Action Coalition (HPAC)

Yolo County Homeless and Poverty Action Coalition (HPAC) Yl Cunty Hmeless and Pverty Actin Calitin (HPAC) FY 2017 Emergency Slutins Grant (ESG): Lcal Cmpetitin Timeline and Selectin Prcess Adpted June 9, 2017 Tentative Lcal Emergency Slutins Grant (ESG) Cmpetitin

More information

Council Camp Staff and the Annual Health & Medical Record. CampDoc FAQs

Council Camp Staff and the Annual Health & Medical Record. CampDoc FAQs Cuncil Camp Staff and the Annual Health & Medical Recrd CampDc FAQs What is CampDc? CampDc.cm is an electrnic health recrd system designed by physicians, nurses, and camp directrs fr use in camps. Web-based

More information

IHSS In Home Support Services

IHSS In Home Support Services IHSS In Hme Supprt Services What is IHSS? The IHSS prgram is a statewide mandated prgram administered by each cunty under the directin f the Califrnia Department f Scial Services. It prvides thse with

More information

BEHAVIORAL HEALTH STAFF COVERAGE PROTOCOL. Psychiatrist and Psychologist Coverage Plan...4. Telemedicine.7

BEHAVIORAL HEALTH STAFF COVERAGE PROTOCOL. Psychiatrist and Psychologist Coverage Plan...4. Telemedicine.7 BEHAVIORAL HEALTH STAFF COVERAGE PROTOCOL Scial Service Prvider Cverage Plan. 2 Psychiatrist and Psychlgist Cverage Plan.....4 Telemedicine.7 1 SOCIAL SERVICE PROVIDER COVERAGE PLAN In situatins where

More information

Original Date: January 27, 2010 Reviewed/Last Modified Date: September 15, 2015

Original Date: January 27, 2010 Reviewed/Last Modified Date: September 15, 2015 Hme and Cmmunity Care - Feedback Reprting Prcess: Cmplaints, Cmpliments and Inquiries Manual: Administratin Sectin: Risk and Safety Management Subsectin: Original Date: January 27, 2010 Reviewed/Last Mdified

More information

Geofencing in ehealth

Geofencing in ehealth Gefencing in ehealth Mbile Services Prject by Fatimah Zahra (7515) Faculty f Cmputer Science Free University f Bzen-Blzan Italy, 2009 Cntents Cntents...2 Figures...2 1. Intrductin...3 2. System Functins...3

More information

September 26, Dear Chairman Tiberi:

September 26, Dear Chairman Tiberi: September 26, 2017 United States Huse f Representatives Cmmittee n Ways & Means 1102 Lngwrth Huse Office Building Washingtn D.C. 20515 WMPrviderFeedback@mail.huse.gv Dear Chairman Tiberi: Thank yu fr the

More information

Boston University. Advocate Applicant Information Packet Spring Tony Kushner

Boston University. Advocate Applicant Information Packet Spring Tony Kushner Bstn University The wrld is calling; heal the wrld and in the prcess heal yurself, find the human in yurself by finding the citizen, the activist, the her. Tny Kushner Advcate Applicant Infrmatin Packet

More information

Improving Inpatient Discharge Cycle Time and Patient Satisfaction

Improving Inpatient Discharge Cycle Time and Patient Satisfaction Imprving Inpatient Discharge Cycle Time and Patient Satisfactin An SBTI White Paper Clumbus Reginal Hspital (CRH) is a 325-bed hspital prviding care t a 10-cunty service area surrunding Clumbus, Indiana.

More information

2018 CMS Web Interface

2018 CMS Web Interface CMS Web Interface CARE-1 (NQF 0097): Medicatin Recnciliatin Pst- Discharge Measure Steward: NCQA CMS Web Interface V2.0 Page 1 f 20 11/13/2017 Cntents INTRODUCTION...3 CMS WEB INTERFACE SAMPLING INFORMATION...4

More information

Medical Home. update. Western Montana Region- PCMH Implementation and the Varying HIT Components & Impacts. May 16, 2014

Medical Home. update. Western Montana Region- PCMH Implementation and the Varying HIT Components & Impacts. May 16, 2014 Medical Hme update Western Mntana Regin- PCMH Implementatin and the Varying HIT Cmpnents & Impacts May 16, 2014 Agenda Current Medical Hme Status- Prvidence WMT Applicatin- HIT determinants Wrkflw- Patient

More information

Meaningful Use - Menu Measure 4 Family History Configuration Guide

Meaningful Use - Menu Measure 4 Family History Configuration Guide Enterprise EHR Meaningful Use - Menu Measure 4 Family Histry Cnfiguratin Guide Last Updated: January 21, 2014 Cpyright 2013 Allscripts Healthcare, LLC. www.allscripts.cm MU Menu 04 Family Histry This guide

More information

Practice Improvement Network (PIN) Project Application

Practice Improvement Network (PIN) Project Application Practice Imprvement Netwrk (PIN) The Practice Imprvement Netwrk (PIN) The PIN is the utpatient, ambulatry netwrk f the Quality Imprvement Innvatin Netwrks (QuIIN). As QuIIN evlved frm a netwrk f practicing

More information

For purposes of this Security Agreement, the use of the terms you and your includes both the Oil and Gas Operator and the EFA when appropriate.

For purposes of this Security Agreement, the use of the terms you and your includes both the Oil and Gas Operator and the EFA when appropriate. Oil and Gas Operatr and Electrnic Filing Administratr (EFA) Registratin and Security Agreement fr Oil and Gas Electrnic Filing Systems Oil and Gas Operatr (Primary Reprting Entity) Name f Oil and Gas Operatr:

More information

Obtain an official copy of your PN transcript to submit with this packet.

Obtain an official copy of your PN transcript to submit with this packet. Advanced Placement Packet fr LPNs fr Spring 2018 Deadline fr packet submissin: 11/16/17 It is pssible t receive credit fr yur LPN experience and begin the RN prgram at Crning Cmmunity Cllege. Advanced

More information

2018 HBS New Venture Competition Student Social Enterprise Track

2018 HBS New Venture Competition Student Social Enterprise Track 2018 HBS New Venture Cmpetitin Student Scial Enterprise Track Details fr Participating Teams KEY DATES See details fr each n fllwing pages Date January 31, 2018 12:00 nn February 21, 2018 12:00 nn March

More information

SC Launch Grant Programs Qualifications and Processing Procedures Effective August 1, 2017

SC Launch Grant Programs Qualifications and Processing Procedures Effective August 1, 2017 SC Launch Grant Prgrams Qualificatins and Prcessing Prcedures Effective August 1, 2017 SCRA s SC Launch Prgram supprts entrepreneurs, increases technlgy cmmercializatin, and fsters early-stage cmpany develpment

More information

Obtaining Controlled Drugs In Primary Care - Supply Routes In Exceptional Circumstances

Obtaining Controlled Drugs In Primary Care - Supply Routes In Exceptional Circumstances Obtaining Cntrlled Drugs In Primary Care - Supply Rutes In Exceptinal Circumstances C-rdinatrs: Lesley Thmsn Lead Pharmacist Cntrlled Drugs Team Cnsultatin Grup: Apprver: David Pfleger Cntrlled Drug Accuntable

More information

Bulletin. Required Activity: Admission to Medicaid-Certified Nursing Facilities and 90-day Redetermination TOPIC PURPOSE CONTACT SIGNED

Bulletin. Required Activity: Admission to Medicaid-Certified Nursing Facilities and 90-day Redetermination TOPIC PURPOSE CONTACT SIGNED Bulletin NUMBER #17-25-06 DATE August 7, 2017 OF INTEREST TO Cunty Directrs Scial Services Supervisrs and Staff Tribal Health Directrs Lng Term Care Cnsultatin Cntacts Nursing Facility Prviders Hspital

More information

Barnett Wood Pre-School. Medication Policy and Procedure

Barnett Wood Pre-School. Medication Policy and Procedure Barnett Wd Pre-Schl Medicatin Plicy and Prcedure Cntents: Our Aim General Pints Our Prcedures Prescriptin Medicatin Strage f Medicatin Outings and Trips Nn-prescribed Medicatin Self-held Medicatin Prir

More information

SAMPLE- Visit FirehouseSubsFoundation.org to apply online. Firehouse Subs Public Safety Foundation Grant Application

SAMPLE- Visit FirehouseSubsFoundation.org to apply online. Firehouse Subs Public Safety Foundation Grant Application SAMPLE- Visit FirehuseSubsFundatin.rg t apply nline. Firehuse Subs Public Safety Fundatin Grant Applicatin 1 SAMPLE- Visit FirehuseSubsFundatin.rg t apply nline. Cngratulatins! Yur rganizatin has met Firehuse

More information

Home Modifications Enrolment Form

Home Modifications Enrolment Form Hme Mdificatins Enrlment Frm Please answer all questins t cmplete yur Hme Mdificatins enrlment Persnal details 1. Enter yur full name Family Name (Surname) Given Names 2. Enter yur birth date Day/mnth/year

More information

Application. Community Health Excellence (CHE) Grant Program

Application. Community Health Excellence (CHE) Grant Program Cmmunity Health Excellence (CHE) Grant Prgram 2017 2018 Applicatin A cmpleted applicatin must be submitted by July 30, 2017, and must include: A cmpleted Applicatin Cver Sheet and Narrative A cmpleted

More information

About this guide 5 Section 1: Meeting VET sector requirements 7

About this guide 5 Section 1: Meeting VET sector requirements 7 Cntents Abut this guide 5 Sectin 1: Meeting VET sectr requirements 7 1.1 Hw Aspire s resurces assist in meeting requirements 7 1.2 Resurce quality assurance prcesses 16 Sectin 2: Unit f cmpetency infrmatin

More information

Critical Access Behavioral Health Agency (CABHA) UPDATE

Critical Access Behavioral Health Agency (CABHA) UPDATE Critical Access Behaviral Health Agency (CABHA) UPDATE Jint Legislative Oversight Cmmittee n MH/DD/SAS April 14, 2010 Michael Watsn Assistant Secretary fr MH/DD/SAS Develpment Department f Health and Human

More information

SERVICES COVERED BY PHP FamilyCare

SERVICES COVERED BY PHP FamilyCare SERVICES COVERED BY PHP FamilyCare PHP FamilyCare cvers the same services that Medicaid des. Cverage is nt available unless the service is medically necessary. Cverage is als nt available unless the service

More information

Our Epic Project Frequently Asked Questions

Our Epic Project Frequently Asked Questions Our Epic Prject Frequently Asked Questins What is EPIC? EPIC is a state-f-the art integrated infrmatin system that cmbines all available patient infrmatin in a single database t imprve all caregivers ability

More information

PLACEMENT POLICIES FOR WORK & TRAVEL AND TRAINEE/INTERN PROGRAMS

PLACEMENT POLICIES FOR WORK & TRAVEL AND TRAINEE/INTERN PROGRAMS PLACEMENT POLICIES FOR WORK & TRAVEL AND TRAINEE/INTERN PROGRAMS TABLE OF CONTENTS Wrk & Travel Prgram Submissin Prcess 1 Placement Prcedures 2 Trainee/Intern Prgram Submissin Prcess 3 Placement Prcedures

More information

2017 TOURISM DEVELOPMENT MATCHING GRANT PROGRAM PROGRAM GUIDELINES

2017 TOURISM DEVELOPMENT MATCHING GRANT PROGRAM PROGRAM GUIDELINES 2017 TOURISM DEVELOPMENT MATCHING GRANT PROGRAM PROGRAM GUIDELINES The Fauquier Cunty Department f Ecnmic Develpment has established a Turism Develpment Matching Grant Prgram. The grant prgram is administered

More information

Use of Fixed Term Contracts within. This document is intended to support managers and staff understand the use of fixed term contracts

Use of Fixed Term Contracts within. This document is intended to support managers and staff understand the use of fixed term contracts Name Use f Fixed Term Cntracts Summary This dcument is intended t supprt managers and staff understand the use f fixed term cntracts Target audience All staff Versin number 1 PIN plicy Use f Fixed Term

More information

Quality Standards. Palliative Care Measurement Guide. April 2018

Quality Standards. Palliative Care Measurement Guide. April 2018 Quality Standards Palliative Care Measurement Guide April 2018 Cntents 1 Hw t Use the Measurement Guide... 3 2 Quality Indicatrs in Quality Standards... 4 2.1 Measurement Principles... 4 2.2 Prcess Indicatrs...

More information

COMMUNITY PHARMACY WARFARIN SERVICE Community Pharmacy Anti-coagulation Management (CPAM) Service

COMMUNITY PHARMACY WARFARIN SERVICE Community Pharmacy Anti-coagulation Management (CPAM) Service COMMUNITY PHARMACY WARFARIN SERVICE Cmmunity Pharmacy Anti-cagulatin Management (CPAM) Service Intrductin INFORMATION FOR GENERAL PRACTICE In cuntries such as the UK, Australia, Canada and USA anticagulant

More information

Each Home Instead Senior Care franchise office is independently owned and operated Home Instead, Inc.

Each Home Instead Senior Care franchise office is independently owned and operated Home Instead, Inc. Each Hme Instead Senir Care franchise ffice is independently wned and perated. 2010 Hme Instead, Inc. The nrmal aging prcess, which may invlve sensry lss, decline in memry, and slwer prcessing f infrmatin

More information

Black Country BeActive Partnership Inspired Coaches Application Form

Black Country BeActive Partnership Inspired Coaches Application Form Black Cuntry BeActive Partnership Inspired Caches Applicatin Frm Guidance Ntes Please visit www.blackcuntrybeactive.c.uk fr guidance n Funding aims Wh can apply? Hw are applicatins assessed? Payment (Payment

More information

Secure Blue (PPO) 2016 Evidence of Coverage. January 1 December 31, 2016

Secure Blue (PPO) 2016 Evidence of Coverage. January 1 December 31, 2016 Secure Blue (PPO) 2016 Evidence f Cverage January 1 December 31, 2016 Yur Medicare Health Benefits and Services Cverage as a Member f Secure Blue (PPO) This bklet gives yu the details abut yur Medicare

More information

2017 CMS Web Interface

2017 CMS Web Interface CMS Web Interface CARE-1 (NQF 0097): Medicatin Recnciliatin Pst- Discharge Measure Steward: NCQA Web Interface V1.0 Page 1 f 20 11/15/2016 Cntents INTRODUCTION... 3 WEB INTERFACE SAMPLING INFORMATION...

More information

Medical Assistant Program Western Technical College. Supplemental Information

Medical Assistant Program Western Technical College. Supplemental Information Medical Assistant Prgram Western Technical Cllege Supplemental Infrmatin Curse Sequence and Delivery. This is a tw-term prgram. During the first term, the student cmpletes the basic r fundatinal curses.

More information

FLORIDA CHILD CARE DIRECTOR CREDENTIAL AND RENEWAL APPLICATION

FLORIDA CHILD CARE DIRECTOR CREDENTIAL AND RENEWAL APPLICATION FLORIDA CHILD CARE DIRECTOR CREDENTIAL RENEWAL APPLICATION RESOURCE PAGE A directr credential is required fr each licensed child care facility and Vluntary Pre-Kindergarten (VPK) Prgram. The directr credential

More information

Medical Cannabis Program

Medical Cannabis Program Medical Cannabis Prgram Website: www.nmhealth.rg/g/mcp Telephne Number: 505-827-2321 Checklist fr Patient Applicatins This checklist is fr new applicants and current patients ( renewing patients). Yu can

More information

GRANT GUIDELINES FOR ORGANIZATIONS 2017 CYCLE

GRANT GUIDELINES FOR ORGANIZATIONS 2017 CYCLE GRANT GUIDELINES FOR ORGANIZATIONS 2017 CYCLE SUBMISSION DEADLINE Thursday, March 30, 2017 at 5:00 PM GRANTS PROGRAM OVERVIEW CultureWrks missin is t drive a vibrant cmmunity by inspiring, enabling and

More information

ADULT HOME HEALTH CARE REFERRAL MRN # LAST NAME FIRST NAME BIRTHDATE SEX NATIONAL ORIGIN

ADULT HOME HEALTH CARE REFERRAL MRN # LAST NAME FIRST NAME BIRTHDATE SEX NATIONAL ORIGIN 2000 Summer St NE, Ste 100 Minneaplis, MN 55413 612.617.4600 ADULT HOME HEALTH CARE REFERRAL MRN # LAST NAME FIRST NAME BIRTHDATE SEX NATIONAL ORIGIN SOCIAL SECURITY # PHONE M F White Asian Pacific Black

More information

BROCKTON AREA MULTI-SERVICES, INC. ORGANIZATION AND POLICY GUIDE

BROCKTON AREA MULTI-SERVICES, INC. ORGANIZATION AND POLICY GUIDE Page 1 f 12 PURPOSE: T ensure cmpliance with 105 CMR 700.003 regulatins regarding strage and dispensing f medicatins in cmmunity residences; t ensure the health and safety f individuals served; and t prvide

More information

ICD-10 Provider Frequently Asked Questions Online Specialty Education

ICD-10 Provider Frequently Asked Questions Online Specialty Education ICD-10 Prvider Frequently Asked Questins Online Specialty Educatin What specialty educatin mdules are available in The Cmmns? Anesthesilgy Bariatric Surgery Breast Surgery Cardiac Electrphysilgy Cardiac

More information

Closing Date for Applications - no applications accepted after midnight (UK Time) on closing date First review of applications begins

Closing Date for Applications - no applications accepted after midnight (UK Time) on closing date First review of applications begins Guidance ntes Research and Develpment Department 1. CIMA S RESEARCH APPLICATION PROCESS CIMA s charter t advance the science f management accunting frms the cre f ur academic research strategy and guides

More information

CANADIAN FOUNDATION FOR DIETETIC RESEARCH LA FONDATION CANADIENNE DE LA RECHERCHE EN DIETETIQUE

CANADIAN FOUNDATION FOR DIETETIC RESEARCH LA FONDATION CANADIENNE DE LA RECHERCHE EN DIETETIQUE CANADIAN FOUNDATION FOR DIETETIC RESEARCH LA FONDATION CANADIENNE DE LA RECHERCHE EN DIETETIQUE CFDR Research Shwcase DC Cnference 2018 Late Breaking Abstract Submissin Infrmatin The Canadian Fundatin

More information

Guide to Complete the Steps for Foreign-Trained Nurses to Obtain the Maryland Registered Nurse (RN) License

Guide to Complete the Steps for Foreign-Trained Nurses to Obtain the Maryland Registered Nurse (RN) License Guide t Cmplete the Steps fr Freign-Trained Nurses t Obtain the Maryland Registered Nurse (RN) License Welcme Back Center Suburban Maryland Mntgmery Cunty, Maryland Department f Health and Human Services

More information

health. Our focus Summary of Benefits Health Partners Medicare Special (HMO SNP)

health. Our focus Summary of Benefits Health Partners Medicare Special (HMO SNP) Yur health. Our fcus. 2018 Summary f Benefits Health Partners Medicare Special (HMO SNP) 2018 Summary f Benefits Health Partners Medicare (H9207) Health Partners Medicare Special (HMO SNP) (plan 004) This

More information

OLTL Transition Plan CMS HCBS Regulations. Introduction

OLTL Transition Plan CMS HCBS Regulations. Introduction OLTL Transitin Plan CMS HCBS Regulatins Intrductin New Centers fr Medicare and Medicaid Services (CMS) rules utlined at 42 CFR 441.301(c)(4) require public cmment n any new 1915(c) waivers, waiver renewals

More information

2018 FLAS Application Questions

2018 FLAS Application Questions Page 1 f Applicatin 2018 FLAS Applicatin Questins Applicatin Type Instructins: Up t tw chices allwed. Summer applicatins and Academic Year applicatins are reviewed separately, even thugh they share an

More information

TRAINING PLAN FOR STEM OPT STUDENTS

TRAINING PLAN FOR STEM OPT STUDENTS 1 CmpletingtheFrmI983 TRAININGPLANFORSTEMOPTSTUDENTS Science, Technlgy, Engineering & Mathematics (STEM) Optinal Practical Training (OPT) STEMOPTstudentsandtheiremplyersaresubjecttthetermsftheFrmI983,TrainingPlanfr

More information

Directions & Instructions for Filing an Application to the Radiologic Technology Program

Directions & Instructions for Filing an Application to the Radiologic Technology Program 2018 Radilgic Technlgy Applicatin Infrmatin Page 1 f 7 Ls Angeles City Cllege Radilgic Technlgy Prgram APPLICATION INFORMATION PACKET Applicatin Filing Perid is February 1, 2018 t March 31, 2018 Directins

More information

After School Part Time 3-5 days per week. 1-2 days per week $234 $140

After School Part Time 3-5 days per week. 1-2 days per week $234 $140 June 15, 2015 Dear Parents/Guardians: Welcme t the Ott Family YMCA Afterschl Prgram fr schl year 2015-2016. The fllwing frms must be filled ut and returned t the Ott Family YMCA befre yur child can attend

More information

DEADLINE FOR APPLICATION SUBMISSION is March 12, 2018.

DEADLINE FOR APPLICATION SUBMISSION is March 12, 2018. Schlarship Awards DEADLINE FOR APPLICATION SUBMISSION is March 12, 2018. There is ne applicatin fr all fur schlarships, yu will be cnsidered fr any which yu are eligible. In additin t specific eligibility

More information

A retired employee or past employee who was employed full-time by a governmental entity in Broward County continuously for at least five years.

A retired employee or past employee who was employed full-time by a governmental entity in Broward County continuously for at least five years. 2017 2018 SCHOLARSHIP APPLICATION RALPH H. AND RUTH FRANK GROSS MEMORIAL SCHOLARSHIP Ralph and Ruth Frank Grss understd the value f a gd educatin. This schlarship was established in memry f them and is

More information

SEQOHS Accreditation Assessor Job Description

SEQOHS Accreditation Assessor Job Description SEQOHS Accreditatin Assessr Jb Descriptin Abut this Dcument This dcument supprts the SEQOHS Office prcess fr the recruitment f assessrs fr the SEQOHS accreditatin scheme. Assessrs must be frm an ccupatinal

More information

NHS TAYSIDE. Special Formulation and Unlicensed Products in Primary Care. A Guide for Pharmacists Working Within NHS Tayside

NHS TAYSIDE. Special Formulation and Unlicensed Products in Primary Care. A Guide for Pharmacists Working Within NHS Tayside NHS TAYSIDE Special Frmulatin and Unlicensed Prducts in Primary Care A Guide fr Pharmacists Wrking Within NHS Tayside Guideline Manager Diane Rbertsn, Principal Pharmacist, Cmmunity Pharmacy Develpment

More information

Instructions. Important Dates. Application Deadline: May 15, 2013 at 5:00 p.m. Grant Awards Announced: July 15, 2013

Instructions. Important Dates. Application Deadline: May 15, 2013 at 5:00 p.m. Grant Awards Announced: July 15, 2013 Instructins Imprtant Dates Applicatin Deadline: May 15, 2013 at 5:00 p.m. Grant Awards Annunced: July 15, 2013 Prject Cmpletin: December 31, 2014 CONTACT: Lancaster Cunty Cnservancy Fritz Schreder PO Bx

More information

Outbreak Investigation Team Roles and Responsibilities

Outbreak Investigation Team Roles and Responsibilities COMMUNICABLE DISEASE OUTBREAK MANUAL New Jersey s Public Health Respnse Outbreak Investigatin Team Rles and Respnsibilities BUILDING THE INVESTIGATION TEAM Befre an utbreak, identify key individuals wh

More information

Admission Agreement (SMOKE FREE CAMPUSES)

Admission Agreement (SMOKE FREE CAMPUSES) Chse One: PEC PTCC Prvidence Extended Care, and Prvidence Transitinal Care Center, cllectively (d.b.a) Prvidence Anchrage Lng Term Care Services hereinafter referred t as PEC/PTCC/PALTCS respectively.,

More information

Community Health Worker / Certified Recovery Specialist Training Application

Community Health Worker / Certified Recovery Specialist Training Application APPLICANTS REQUIRED TO COMPLETE APPLICATION WITHOUT ASSISTANCE FROM OTHERS $35 Applicatin Fee is nn-refundable Applying des NOT guarantee admissin int training Date f Applicatin: First Name: Last Name:

More information

FOCUS AREA 1: Creative use of Existing Infrastructure for Future Transportation Needs:

FOCUS AREA 1: Creative use of Existing Infrastructure for Future Transportation Needs: Request fr Applicatins: DISSERTATION & THESIS FELLOWSHIPS 1. Overview The Center fr Transprtatin Equity, Decisins and Dllars (CTEDD) invites qualified applicants t apply fr Spring 2018 Dctral Dissertatin

More information

Financial Officer 18 Applicant Inventory

Financial Officer 18 Applicant Inventory Financial Officer 18 Applicant Inventry Frequently Asked Questins Why has an applicant inventry been created t fill Financial Officer 18 vacancies? The creatin f applicant inventries allws fr a mre cnsistent

More information

MEDI-CAL (MC051) ERA ENROLLMENT INSTRUCTIONS

MEDI-CAL (MC051) ERA ENROLLMENT INSTRUCTIONS MEDI-CAL (MC051) ERA ENROLLMENT INSTRUCTIONS WHICH FORM(S) SHOULD I DO? Electrnic Healthcare Claim Payment/Advice Receiver Agreement (ANSI ASC X12N 835-Transactin) WHERE SHOULD I SEND THE FORMS? Mail the

More information

ABI Forum of the CT Community Nonprofit Alliance

ABI Forum of the CT Community Nonprofit Alliance Date: January 16, 2017 ABI Frum f the CT Cmmunity Nnprfit Alliance T: The Hnrable Representative Abercrmbie Frm: Julia Wilcx, Senir Public Plicy Specialist, CT Cmmunity Nnprfit Alliance (The Alliance)

More information

Voluntary Pre-Offer Self-Identification of Protected Veteran Status

Voluntary Pre-Offer Self-Identification of Protected Veteran Status Vluntary Pre-Offer Self-Identificatin f Prtected Veteran Status This emplyer is a Gvernment cntractr subject t the Vietnam Era Veterans' Readjustment Assistance Act f 1974, as amended by the Jbs fr Veterans

More information

Medical Assistance in Dying: Update Stakeholder Presentation

Medical Assistance in Dying: Update Stakeholder Presentation Medical Assistance in Dying: Update Stakehlder Presentatin Ministry f Health and Lng-Term Care and Ministry f the Attrney General Week f August 1, 2016 Implementatin Questins: What We Heard Frm Yu 1. Reprting:

More information

DOCUMENT TITLE: Clarification of Bureau of Primary Health Care Credentialing and Privileging Policy outlined in Policy Information Notice

DOCUMENT TITLE: Clarification of Bureau of Primary Health Care Credentialing and Privileging Policy outlined in Policy Information Notice 2002-22 DATE: July 10, 2002 DOCUMENT TITLE: Clarificatin f Bureau f Primary Health Care Credentialing and Privileging Plicy utlined in Plicy Infrmatin Ntice 2001-16 TO: Cmmunity Health Centers Migrant

More information

PAPER FOR NHS LUTON COMMUNITY SERVICES BOARD MEETING HELD ON 21 ST APRIL 2010

PAPER FOR NHS LUTON COMMUNITY SERVICES BOARD MEETING HELD ON 21 ST APRIL 2010 PAPER FOR NHS LUTON COMMUNITY SERVICES BOARD MEETING HELD ON 21 ST APRIL 2010 TITLE AUTHOR(S) PRESENTED BY DIRECTOR S SIGNATURE PURPOSE/ SUMMARY DECISION REQUIRED Standards fr Better Health & CQC Registratin

More information

Changes in the Scope of Practice Environment for Nurse Practitioners in Michigan

Changes in the Scope of Practice Environment for Nurse Practitioners in Michigan Changes in the Scpe f Practice Envirnment fr Nurse Practitiners in Michigan It has been an exciting and interesting year in the plicy wrld fr NP practice in Michigan. The changes that have ccurred happened

More information

Pressure Injury Quality Improvement Strategies

Pressure Injury Quality Improvement Strategies Pressure Injury Quality Imprvement Strategies M A R G A R E T W I L B E R, R N, B S N S H A R O N M O O R E ANP- B C, W O C N B R I A N L E H M A N O C T O B E R 1 7, 2 0 1 7 Pressure Injury Quality Imprvement

More information

Choose Pharmacy Application Frequently Asked Questions (FAQs)

Choose Pharmacy Application Frequently Asked Questions (FAQs) Chse Pharmacy Applicatin Frequently Asked Questins (FAQs) What is Chse Pharmacy? Wh develped the Chse Pharmacy applicatin? Wh can use the Chse Pharmacy applicatin? Des Chse Pharmacy integrate with the

More information