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INTEGRITY AGREEMENT BETWEEN THE OFFICE OF INSPECTOR GENERAL OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES AND NOSHEEN HASAN, M.D. AND CENTER FOR PAIN MANAGEMENT, S.C.I.PREAMBLENosheen Hasan, M.D.

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This guide provides a comprehensive overview of how to fill out the Nosheen Hasan form online. We will walk you through each section and field, ensuring that you have all the information needed to complete the process smoothly and accurately.

Follow the steps to successfully complete the Nosheen Hasan form online.

  1. Press the ‘Get Form’ button to access the document. This action allows you to open the form in your chosen editor.
  2. Begin with the preamble section, which outlines the purpose of the agreement. Ensure to read the details closely to understand the commitments involved.
  3. Fill out the term and scope of the Integrity Agreement by specifying the effective date and the duration of three years as highlighted in the document.
  4. Identify all 'Covered Persons' within your organization. Provide the necessary information regarding the individuals and their roles as outlined in section III.
  5. Complete the integrity obligations section, including the appointment of the Compliance Officer and the development of policies and procedures.
  6. Provide information on the training and education programs for all Covered Persons, ensuring compliance with the necessary training requirements.
  7. Complete the review procedures for the Independent Review Organization, including documentation of claims and any necessary audits.
  8. Once all fields are filled, review the document to ensure accuracy. Save changes, and when ready, download or print the completed form.
  9. Submit the completed form as per the provided guidelines, ensuring to keep copies for your records.

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