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How to use or fill out 08-14 FORM CMS-1984-14 4390 Cont Rev 1 43-101 - iahhc with our platform
- Click ‘Get Form’ to open it in the editor.
- Begin by entering your PROVIDER CCN and the reporting PERIOD (FROM and TO dates) at the top of the form.
- In PART I - COST REPORT STATUS, select the appropriate options for electronic filing or manual submission, and fill in any amendments made to the cost report.
- Proceed to PART II - CERTIFICATION. Ensure that an officer or administrator certifies the accuracy of the information provided by signing and dating where indicated.
- Complete HOSPICE IDENTIFICATION DATA by filling in all required fields such as Name, Address, and Certification Date.
- For each WORKSHEET section, carefully input data regarding costs, statistical data, and reimbursement details as per your records.
- Review all entries for accuracy before saving or submitting your completed form through our platform.
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