Get Revenue Cycle Assessment Project Commitment - Kansas ...

Navigating the Revenue Cycle Assessment Project Commitment form can ensure your facility's effective participation in the improvement project. This guide will provide clear instructions for completing the form online, helping you understand each section and its importance.

Follow the steps to successfully fill out your form online.

1. Click the ‘Get Form’ button to access the form and open it in your preferred online tool.
2. In the first section, fill out your facility's name and address, including the city and ZIP code. Ensure accuracy as this information is crucial for correspondence.
3. Enter the names and contact information for your Administrator or CEO, including their email address and phone number. This section identifies the leadership responsible for the commitment.
4. Provide the name and contact details for your CFO or Financial Officer. Again, include their email address and phone number for future communications.
5. Specify the Project Contact Person responsible for communication related to the project. Include their email and phone number.
6. Indicate whether your facility would like to participate in the Revenue Cycle Improvement Project by marking 'YES.' You must understand that participation involves sharing confidential information used for assessment.
7. Sign and date the form in the Administrator/CEO Signature and Date fields. The signature signifies your facility's commitment to the project.
8. After completing the form, you can save your changes, download it for printing, or share it via email as specified. Be sure to send the completed form electronically to asester@kdheks.gov or fax it to (785)296-1231 by the application deadline.

Complete your Revenue Cycle Assessment Project Commitment form online today to ensure your facility's participation in this vital project!