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Showing results for "form".

1. Form an MEPSnet/IC Query Step-by-Step
   meps.ahrq.gov/data_stats/MEPSnetICStepByStep.shtml
   Form an MEPSnet/IC Query Step-by-Step   … S M L XL   Form

2. Microsoft Word - HOSP EVENT FORM 2006 _legal_.doc (pdf file)
   meps.ahrq.gov/survey_comp/misc_survey/mpc/2006/HSP_06.pdf
   January 01, 2006 - Microsoft Word - HOSP EVENT FORM 2006 _legal_.doc OMB#: 0935-0118 PATIENT … LABEL |__|__|__| OFFICE USE ONLY |__|__|__| OFFICE USE ONLY FORM … MEDICAL EXPENDITURE PANEL SURVEY MEDICAL PROVIDER COMPONENT HOSPITAL EVENT FORM … FOR REFERENCE YEAR 2006 2 HOSPITAL EVENT FORM [COMPLETE ONE FORM FOR EACH EVENT] … [RECORD NAMES ON SEPARATELY BILLING DOCTOR FORM.

3. Pmed (pdf file)
   meps.ahrq.gov/data_stats/nhc/pmed.pdf
   September 30, 1997 - " from PM3; Else if form and strength were added to medicine ("ADD FORM AND STRENGTH" was selected in … "FORM" as displayed on the Redbook list. … " FROM PM3; Else if form and strength were added to a selected medicine ("ADD FORM AND STRENGTH" was … " from PM3; Else if form and strength were added to medicine ("ADD FORM AND STRENGTH" was selected in … " FROM PM3; Else if form and strength were added to a selected medicine ("ADD FORM AND STRENGTH" was

4. MEPS - IC Technical Notes
   meps.ahrq.gov/survey_comp/ic_technical_notes.shtml
   January 01, 2020 - governments and very large private-sector firms are collected using specialized staff and forms … Company Form Added company-level forms (15 and 15S) for cases where data collection at the establishment-level … Renumbered questions on the form. … Plan Form Removed HSA instruction under Plan Premium. … Plan Form Added question on employee-plus-one deductible.

5. AHRQ Data Center Application for Access to Restricted MEPS Data (pdf file)
   meps.ahrq.gov/data_stats/data_center_application.pdf
   December 01, 2023 - You can also type the information directly into this form. … You can also type the information directly into this form. 12) List below the MEPS data file(s) and … You can also type the information directly into this form. 14) Are you requesting AHRF data? … You can also type the information directly into this form. 17) Please provide an estimated time … You can also type the information directly into this form. 20) Select below the software to which

6. MEPS
   meps.ahrq.gov/communication/participants/confidentialitypharm.shtml
   Such information may not be published or released in other form if the person who supplied the information … consent is documented through the patient’s signature on the MEPS authorization form … The MEPS authorization form (PDF 202 KB, or HTM 6 KB) was redesigned … in 2002 to meet the HIPAA requirements for authorization forms described in Section 164.508(c) 45 … The revised form was reviewed and deemed HIPAA compliant by the Westat IRB.

7. MEPS
   meps.ahrq.gov/communication/participants/confidentialitymcp.shtml
   Such information may not be published or released in other form if the person who supplied the information … This consent is documented through the patient’s signature on the MEPS authorization form … The MEPS authorization form was redesigned in 2002 to meet the HIPAA requirements for … authorization forms described in Section 164.508(c) 45 CFR 164. … The revised form was reviewed and deemed HIPAA compliant by the Westat IRB.

8. Authorization To Obtain Information OMB #: 0935-0118 PANEL 13
   meps.ahrq.gov/survey_comp/mpc/AuthorizationForms/2008/af_p13_medicalprovider.htm
   January 01, 2008 - This authorization form covers any care I received at your facility during this period, including treatment … This form (or a photocopy of this form) gives you my authorization. … I have signed this form voluntarily, with the understanding that my decision to sign or not to sign the … form will have no effect on my eligibility for treatment, payment, enrollment, or eligibility for any

9. Hlthstat (pdf file)
   meps.ahrq.gov/data_stats/nhc/hlthstat.pdf
   September 30, 1997 - Ranges for determining the validity of the assessment dates for MDS forms are displayed below. … If there are two or more forms completed in the same month and only one has 5 a DAY entry, the form … If no forms dated in the same month have a DAY entry, none are eligible to use as the primary form for … Identify the forms by a “M” or “Q” preceding the section fills. … I am prepared to abstract from the medical record and MDS forms myself.

10. Medical Expenditure Panel Survey - Employer Participant Frequently Asked Questions
    meps.ahrq.gov/communication/employer_participant_faqs.jsp
    I have returned my form. Why have I received another just like it ? … ^top I have returned my form. Why have I received another just like it? … We send follow-up letters and forms when the deadline passes. … Your returned form and our follow-up letter and form may have crossed in the mail. … Some companies receive more than one form so they can report for different lines of business

11. Medical Expenditure Panel Survey - Employer Participant Frequently Asked Questions
    meps.ahrq.gov/mepsweb/communication/employer_participant_faqs.jsp
    I have returned my form. Why have I received another just like it ? … ^top I have returned my form. Why have I received another just like it? … We send follow-up letters and forms when the deadline passes. … Your returned form and our follow-up letter and form may have crossed in the mail. … Some companies receive more than one form so they can report for different lines of business

12. Medical Expenditure Panel Survey Medical Provider Component Data Collection
    meps.ahrq.gov/mepsweb/survey_comp/mpc_data_collection.jsp
    October 01, 2004 - Patients in sampled households were asked to sign authorization forms permitting the data … Institutional Event Form for Non-hospital Facilities. … Office-based Provider Event Form. … Separately Billing Doctors Event Form. … Hospital Event Form.

13. Meps10 (pdf file)
    meps.ahrq.gov/survey_comp/ic_survey/1998/meps10.pdf
    January 01, 1998 - RETURN TO FORM MEPS-10 OMB No. 0935-0105: Approval Expires 12/31/2000 U.S. … PLEASE RETURN ENTIRE PACKAGE WITHIN FORM MEPS-10 (4-27-99) INSTRUCTIONS Paperwork Reduction Act … FORM MEPS-10 (4-27-99) 1 Yes – Continue with Question 1b031 What was the last year your organization … Section D – BUSINESS CHARACTERISTICS FORM MEPS-10 (4-27-99)Page 6 2a. … Section E – GENERAL HEALTH COVERAGE CHARACTERISTICS FORM MEPS-10 (4-27-99) Page 7 2a.

14. Meps10S (pdf file)
    meps.ahrq.gov/survey_comp/ic_survey/1998/meps10s.pdf
    January 01, 1998 - FORM (4-27-99) MEPS-10(S) OMB No. 0935-0105: Approval Expires 12/31/2000 U.S. … PLAN AFFILIATION FORM MEPS-10(S) (4-27-99) Page 3 7. … FAMILY COVERAGE PREMIUMS FORM MEPS-10(S) (4-27-99)Page 4 10a. … PLAN CHARACTERISTICS FORM MEPS-10(S) (4-27-99) Page 7 21. … PLEASE RETAIN A COPY OF THIS FORM FOR YOUR RECORDS CURRENT YEAR PLAN INFORMATION

15. m-hosp4.PDF (pdf file)
    meps.ahrq.gov/survey_comp/misc_survey/mpc/1996/m-hosp4.pdf
    January 01, 1996 - ID: ________________________________________ PATIENT NAME: ____________________________________ FORM … ______ OF ______ MEDICAL EXPENDITURE PANEL SURVEY MEDICAL PROVIDER SURVEY HOSPITAL EVENT FORM PANEL … 1 - YEAR 1 HOSPITAL EVENT FORM [COMPLETE ONE FORM FOR EACH EVENT] QUESTIONS 1 THROUGH 4: TO BE … [RECORD NAMES ON SEPARATELY BILLING DOCTOR FORM. … YES ........................ 1 (GO TO PATIENT ACCOUNTS SECTION (Q5a) OF NEXT EVENT FORM.)

16. Medical Expenditure Panel Survey Publication Details
    meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Working+Paper&opt=2&id=1119
    August 20, 2013 - Also a file containing a BRR replication structure (in the form of a set of half sample indicators) is … also made available so that the users can form BRR replicate weights from the final MEPS weight to compute … weights are useful to compute variances of complex non-linear estimators for which a Taylor linear form

17. Methodology Report #37: Outpatient Prescription Drugs: Data Collection and Editing in the 2021 Medical Expenditure Panel Survey
    meps.ahrq.gov/data_files/publications/mr37/mr37.shtml
    January 19, 2024 - information about medication obtained in 2021, 58.5 percent of pharmacy permission forms … the second and subsequent HC interviews, sample members are asked to sign permission forms … from centralized administrative data for MEPS HC sample members who sign authorization forms … Conditional on having obtained 58.5 percent of signed permission forms sought in the … the Pharmacy Component is derived from all persons in the Household Component who signed permission forms

18. 2022 Health Insurance Cost Study Government Questionnaire (pdf file)
    meps.ahrq.gov/survey_comp/ic_survey/2022/meps11.pdf
    January 01, 2022 - Census Bureau 1201 East 10th Street Jeffersonville, IN 47132-0001 OR Fax to 1-800-447-4613 FORM MEPS … -11 (03-09-2022) https://portal.census.gov FORM MEPS-11 2 §> 3 5 > ¤ 2 9 1 8 2 0 2 9 … Please retain a completed copy of this form for your records. 7. … FORM MEPS-11 §> 3 5 N ¤ 2 9 1 8 2 0 4 5 4 205 Enrolled part-time employees What was the … to complete form.

19. Outpatient Prescription Drugs: Data Collection and Editing in the 2021 Medical Expenditure Panel Survey (pdf file)
    meps.ahrq.gov/data_files/publications/mr37/mr37.pdf
    January 19, 2024 - Signed authorization forms allow pharmacies to respond to the PC of MEPS when it is conducted. … collecting information 4 about medication obtained in 2021, 58.5 percent of pharmacy permission forms … information from centralized administrative data for MEPS HC sample members who sign authorization forms … Conditional on having obtained 58.5 percent of signed permission forms sought in the household interview … the Pharmacy Component is derived from all persons in the Household Component who signed permission forms

20. Meps10S (pdf file)
    meps.ahrq.gov/survey_comp/ic_survey/1996/meps10s.pdf
    January 01, 1996 - FORM (7-7-97) MEPS-10(S) MEDICAL EXPENDITURE PANEL SURVEY (INSURANCE COMPONENT) OMB No. 0935-0098 … Section B – PLAN CHARACTERISTICS – Continued Page 2 FORM MEPS-10(S) (7-7-97) Age? Sex? … Alcohol/substance abuse treatment 180 181 182 Section B – PLAN CHARACTERISTICS – Continued Page 4 FORM … $ .00 $ .00END THIS FORM. 1 2 3 500 Remarks PLEASE RETAIN A COPY OF THIS FORM FOR YOUR RECORDS