Get Ma Application For Massachusetts Case Mix And Charge Data (non-government) 2017-2025

This guide provides step-by-step instructions for completing the MA Application for Massachusetts Case Mix and Charge Data for non-government entities. Whether you are familiar with application processes or new to this, these clear instructions will support you in submitting your application accurately.

Follow the steps to complete your application successfully.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin by filling out the organization and investigator information section. Include the project title, organization name, authorized signatory details, and contact information.
3. Next, provide the fee information. Indicate your status as a researcher or other options and declare whether you are requesting a fee waiver. Make sure to fill out the Fee Remittance Form if applicable.
4. In the project information section, specify how you will use the requested data. Check all applicable uses and provide a summary of your project's purpose and objectives.
5. Indicate whether an Institutional Review Board (IRB) has reviewed your project and include the necessary approval letter or documentation.
6. Specify the datasets you are requesting and justify each dataset's necessity for your project. Be detailed and refer back to your project objectives.
7. Fill out the data elements you are requesting, clarifying the specific data points that are essential for your analysis.
8. Complete the section on data linkage if you intend to link CHIA data with other datasets. Specify the types of data and purpose for each linkage.
9. Prepare your attestation, confirming the accuracy of the information provided and your organization’s responsibility for data privacy and security.
10. Once all sections are completed, review your application for accuracy, attach all required documents, and ensure the application fee is submitted before finalizing.
11. Finally, save your changes, download the application, print it out if needed, or share it as per your organizational procedures.

Take the next step in your research journey by completing the MA Application online today.