Get Nursing Assistant Training And Reimbursement Form For Washington
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How to fill out the Nursing Assistant Training And Reimbursement Form For Washington online
This guide provides a comprehensive overview on how to accurately complete the Nursing Assistant Training And Reimbursement Form For Washington online. Follow these clear instructions to ensure your form is filled out correctly and submitted within the required timeframe.
Follow the steps to effectively complete the reimbursement form.
- Click ‘Get Form’ button to obtain the Nursing Assistant Training And Reimbursement Form and open it for editing.
- In the provider information section, enter the name of your facility. If there has been a name change in the last two years, include the previous name as well.
- Fill in the Medicaid reimbursement percentage. This percentage is calculated from your Medicaid patient days reported on the cost report Schedule N.
- Provide your six-digit SSPS provider number.
- Enter the name and contact details of the person responsible for communication regarding this form.
- Indicate the appropriate telephone number of the contact person.
- Input your seven-digit Medicaid vendor number.
- Provide the fax number and email address of the contact person.
- Select the appropriate quarter for which you are requesting reimbursement and enter the corresponding year.
- Complete the direct care costs section by entering the requested current costs for all specified items. Follow the instructions given for accurate calculations.
- In the operations costs section, list the specified costs for items 1 through 5, as directed, and transfer totals to the reimbursement request form.
- For total costs and reimbursement request, transfer total amounts for the direct care and operations costs to find the overall reimbursement request amount.
- Finally, in the provider authorization section, the Nursing Home Administrator must sign and date the form. Ensure the signature is original.
- Once completed, users can save the changes, download the form, print it, or share it as needed.
Start filling out your Nursing Assistant Training And Reimbursement Form online today to ensure a timely submission.
The fastest way to become a CNA is to complete a training program in as little as four to six weeks. You should enroll in a program that prepares you for the state competency exam. After finishing the program, you can quickly submit your Nursing Assistant Training and Reimbursement Form for Washington to expedite your certification process. This streamlined approach helps you begin your career sooner.
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