Transcription of DATA ANALYSIS REQUEST FOR INFORMATION (RFI) …
{{id}} {{{paragraph}}}
Example: air traffic controller
DATA ANALYSIS REQUEST FOR INFORMATION (RFI) …
DATA ANALYSIS REQUEST FOR INFORMATION (RFI). ZPIC Zone 4 TX, OK, NM, CO. REQUEST Type: Data Carrier INFORMATION SVRS-Sample Overpayment Calculation Date of REQUEST : REQUESTOR'S INFORMATION . Requestor Name: Physical Address: Organization: OIG DOJ/FBI OAG/MFCU (required for Strike Force Other: FedEx delivery). Telephone: E-mail: Mobile Phone: Facsimile: Date Required: Check reason for Date Required: Trial Trial Date _____/_____/_____ Other reason: Business Records Affidavit* Is a scanned electronic copy acceptable? Yes No Required?: No Yes *Affidavits are notarized and can delay delivery of data. REQUIRED CRITERIA FOR CLAIMS REQUEST . Type of Data: Medicare Data Only Medicaid Data Only Both Medicare & Medicaid Data Carrier/MAC Documents (see below).
Title: Data Anaylsis Request for Informatioin (RFI) Form Author: ngidley/jheade3 Subject: Waste, Fraud, and Abuse Keywords: medicare,zpic,rfi,waste,fraud,abuse ...
Loading..
Information
Domain:
Source:
Link to this page:
Please notify us if you found a problem with this document: