Get Citations Affected Ic 16-18-2 Ic 16-21-6-6 Ic 16-39-5-3 - In

Filling out the citations affected form IC 16-18-2, IC 16-21-6-6, IC 16-39-5-3 online is a straightforward process that ensures compliance with the relevant health-related mandates. This guide provides step-by-step instructions to assist you in accurately completing the form.

Follow the steps to effectively complete the form online.

1. Click the ‘Get Form’ button to access the form and open it in your preferred digital format.
2. Begin by entering the required identifying information of the patient. This includes the patient's name, date of birth, and any unique identifiers as requested.
3. Fill out the sections regarding the patient's admission details. Specify the admission source, date of admission, and type of admission (e.g., elective, emergency).
4. Document the diagnosis and procedures performed during the patient’s stay. This includes codes related to diagnoses and a description of surgical procedures, if applicable.
5. Provide discharge information, including the date of discharge and discharge disposition. Ensure that this information is accurate and complete.
6. Indicate the charges associated with the patient's stay, including total charges and average charge per discharge categorized by diagnosis.
7. Once all necessary fields are filled out, review the information for accuracy. It is important to double-check all entries to avoid any errors before submission.
8. After confirming that all information is correct, save changes, and you will be prompted to download, print, or share the filled form as needed.

Start filling out your document online today to ensure compliance and timely submission.