We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • Executive Forms
  • Executive Department HHS Forms
  • Cms-473b 2019

Get Cms-473b 2019-2025

ROOM NUMBERS IN THE HOSPITAL NUMBER OF BEDS IN THE HOSPITAL SURVEY DATE REQUEST FOR EXCLUSION FOR COST REPORTING PERIOD FACILITY NAME AND ADDRESS (City, State, Zip Code) / / to / / MM DD YYYY MM DD YYYY VERIFIED BY ALL CRITERIA UNDER SUBPART B OF PART 412 OF THE REGULATIONS MUST BE MET FOR EXCLUSION FROM MEDICARE’S ACUTE CARE HOSPITAL PROSPECTIVE PAYMENT SYSTEM TAG REGULATION GUIDANCE Verification of hospital attestations may be done by CMS surveyors or MACs as applicable. THE HOSPI.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the CMS-473B online

The CMS-473B is a vital form used for documenting rehabilitation hospital criteria. This step-by-step guide will help you understand how to accurately complete this form online, ensuring compliance with Medicare requirements.

Follow the steps to fill out the CMS-473B form correctly.

  1. Click the ‘Get Form’ button to retrieve the form and open it in the online editor.
  2. Enter the facility name and address including city, state, and zip code in the designated fields.
  3. Indicate the survey date by selecting the appropriate month, day, and year.
  4. Provide the number of beds in the hospital by entering the figure in the specified area.
  5. Fill in the section regarding the related Medicare provider number.
  6. Verify each response as the hospital representative, ensuring all questions are answered truthfully, and cross-reference with appropriate medical personnel if necessary.
  7. Complete each of the regulatory requirements boxes labeled as ‘YES,’ ‘NO,’ or ‘N/A’ based on your assessment.
  8. Review all entries for accuracy before proceeding.
  9. Once completed, you may save your changes, download a copy of the form, print it, or share it as required.

Ensure your form is completed correctly by following these steps and submitting your CMS-473B online.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

r4spmp.pdf
Aug 21, 2020 — The State Payment of Medicare Premiums manual (formerly called “State...
Learn more
CMS Chronic Conditions Data Warehouse (CCW)
CMS Chronic Conditions Data Warehouse (CCW). CCW Condition Algorithms ... 473B, S32.474A...
Learn more
변우석
3 days ago — 신체. 190.3cm[1]|73kg[2]|B형|285mm[3] ; 가족. 아버지...
Learn more

Related links form

Timber Court Condominiums Application - Village Of Arlington Heights Birnadine Mack Scholarship Application - Cspera Spay/Neuter Assistance Application - Popptricities Spot Application Broward Form

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

You can obtain your PS&R by logging into your CMS account and requesting it from the appropriate section. Alternatively, you may contact CMS customer service for assistance. Access to your PS&R is crucial for understanding billing performance.

In medical billing, PSR stands for Patient Status Report. This document provides a detailed account of a patient's billing history and service usage. Being familiar with PSR can enhance billing accuracy and help you understand key metrics in your practice.

Accessing the CMS website is easy; simply navigate to the official CMS URL using any web browser. Ensure you have a reliable internet connection for a smooth experience. Bookmarking the site can help you return easily whenever you need to access forms and information.

Creating a CMS account is a straightforward process. Visit the CMS website and click on the sign-up link, then follow the prompts to enter your personal and professional information. Once registered, you will receive a confirmation email, and you can start accessing CMS resources.

To access CMS, you need to create an account on the CMS website. Be prepared to provide identification details and your professional credentials. Once your account is set up, you will have easy access to all CMS resources, including forms and reports.

PS&R stands for Provider Statistical & Reimbursement Report. This report helps healthcare providers track their billing statistics and reimbursement details. Understanding your PS&R can guide you in optimizing your billing processes and overall performance.

To obtain your PS&R, you can request it through the CMS website. You will usually need to provide your personal and patient information for verification. This report will give you valuable insights into your billing history.

Getting the current version of CMS is essential for accurate billing. You can check for the latest updates on the CMS website or through authorized vendors. Keeping your CMS version up to date ensures compliance with the latest regulatory requirements.

To get a CMS 1500 form, you can either download it online or request physical copies from a local healthcare office. Online platforms like UsLegalForms also provide the option to access these forms in a digital format, making it easier for you to fill them out and submit your claims.

You can obtain CMS 1500 forms through various outlets, including the official CMS website and platforms like US Legal Forms. They offer a user-friendly experience for downloading the forms you need. Make sure to choose the correct version for your submission requirements.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get CMS-473B
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232