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41. Context/Flow Specifications for the Overall CAPI Instrument, MEPS-Household Component: Panel 3 (1998-1999) Consolidated Instrument (pdf file)
    meps.ahrq.gov/survey_comp/overall_p3.pdf
    January 01, 1999 - Page does not require timed responses Navigation links Passed Navigation links are not repetitive Forms … Rule Name Status Description Tagged form fields Passed All form fields are tagged Field descriptions … Passed All form fields have description Alternate Text Rule Name Status Description Figures alternate

42. Context/Flow Specifications for the Overall CAPI Instrument, MEPS-Household Component: Panel 10 (2005-2006) Consolidated Instrument (pdf file)
    meps.ahrq.gov/survey_comp/overall_p10.pdf
    January 01, 2006 - Page does not require timed responses Navigation links Passed Navigation links are not repetitive Forms … Rule Name Status Description Tagged form fields Passed All form fields are tagged Field descriptions … Passed All form fields have description Alternate Text Rule Name Status Description Figures alternate

43. MEPS
    meps.ahrq.gov/communication/participants/faq_pharm.shtml
    By signing the MEPS Authorization Form, your customers have asked … household participants have signed HIPAA-compliant authorization forms

44. MEPS Medical Provider Component (MPC) Glossary
    meps.ahrq.gov/survey_comp/appendix_d_glossary.shtml
    December 31, 2020 - AF (Authorization Form): Consent form signed by a household respondent during one … Authorization Form: See AF. … Contact Guide (also POC module): Data collection forms used in the MPC to collect … Event Forms: Data collection forms used in the MPC to collect information about medical … Permission Form: The Authorization Form complies with the requirements of the Health

45. 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.)

46. Medical Expenditure Panel Survey Medical Provider Component (MPC) Glossary (pdf file)
    meps.ahrq.gov/survey_comp/appendix_d_glossary.pdf
    December 31, 2020 - AF (Authorization Form): Consent form signed by a household respondent during one of the household interviews … Authorization Form: See AF. … Event Forms: Data collection forms used in the MPC to collect information about medical events. … Mental Health Counseling (Psychotherapy): A treatment technique for certain forms of mental disorders … Permission Form: The Authorization Form complies with the requirements of the Health Insurance Portability

47. Methodology Report #29: Outpatient Prescription Drugs: Data Collection and Editing in the 2011 Medical Expenditure Panel Survey
    meps.ahrq.gov/data_files/publications/mr29/mr29.shtml
    March 12, 2014 - Signed authorization forms allow pharmacies to respond to the Pharmacy Component (PC) of MEPS when it … interviews collecting information about medication obtained in 2011, 69.7 percent of pharmacy permission forms … During the second, third, fourth, and fifth HC interviews, sample members are asked to sign permission forms … Conditional on having obtained 69.7 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

48. Medical Expenditure Panel Survey Data Overview
    meps.ahrq.gov/mepsweb/data_stats/data_overview.jsp
    April 22, 2019 - Provider Component: Contact guides Survey questionnaires Authorization Forms … Component   Insurance Component Insurance Component data are available online (in tabular form

49. Medical Expenditure Panel Survey Data Overview
    meps.ahrq.gov/data_stats/data_overview.jsp
    April 22, 2019 - Provider Component: Contact guides Survey questionnaires Authorization Forms … Component   Insurance Component Insurance Component data are available online (in tabular form

50. MEPS 2021 Help Text
    meps.ahrq.gov/survey_comp/Helptext2022.html
    January 01, 2022 - For MPC authorization forms, prepare one Authorization Form for each person-provider pair displayed by … For Pharmacy authorization forms, prepare one Authorization Form for each person-pharmacy pair displayed … If the AFs are to be returned by mail, leave an Authorization Form Booklet, the forms, a storage envelope … These amounts can be found on forms 1099-INT or 1099-OID. … Thank you for taking the time to sign authorization forms.

51. MEPS 2023 Help Text
    meps.ahrq.gov/survey_comp/Helptext2023.html
    January 01, 2023 - For MPC authorization forms, prepare one Authorization Form for each person-provider pair displayed … For Pharmacy authorization forms, prepare one Authorization Form for each person-pharmacy pair … If the AFs are to be returned by mail, leave an Authorization Form Booklet, the forms, a storage envelope … These amounts can be found on forms 1099-INT or 1099-OID. … Thank you for taking the time to sign authorization forms.

52. Methodology Report #3: Design and Methods of the 1996 Medical Expenditure Panel Survey Nursing Home Component (pdf file)
    meps.ahrq.gov/data_files/publications/mr3/mr3.pdf
    September 01, 1998 - provides a questionnaire mechnism to collect data for persons with no MDS forms. … MDS forms can also vary by State (e.g., because of waivers). … As a result, not all MDS health status items are located on all MDS forms. … ✓ Tablet 100 MG Tablet 300 MG ADD FORM AND STRENGTH USE ARROW KEYS. … For the next question—”In what form and strength was ALLOPURINOL?”

53. Methodology Report #9: Design, Methods, and Field Results of the 1996 Medical Expenditure Panel Survey Medical Provider Component (pdf file)
    meps.ahrq.gov/data_files/publications/mr9/mr9.pdf
    May 01, 2000 - Many information products have an electronic ordering form and are mailed free of charge from the AHRQ … The HC is the core survey, and it forms the basis for the MPC sample and part of the IC sample. … Only providers for whom the respondent completed a signed permission form authorizing contact were candidates … As stated previously, only providers for which sample persons had signed permission forms were fielded … Refusal to participate (including unwillingness to accept signed permission forms) accounted for about

54. Medical Expenditure Panel Survey - Household Participant Frequently Asked Questions
    meps.ahrq.gov/communication/household_participant_faqs.jsp
    copy of the Record Keeper for your use, there are two versions to choose from, namely: (1) Simple Form … (English) (PDF 89 KB) or Simple Form (Spanish) (PDF 86 KB), which are simple PDF files that people … can print out and use a hard copy, or (2) Fillable Form (English) (PDF 1,001 KB) or Fillable Form

55. Medical Expenditure Panel Survey - Household Participant Frequently Asked Questions
    meps.ahrq.gov/mepsweb/communication/household_participant_faqs.jsp
    copy of the Record Keeper for your use, there are two versions to choose from, namely: (1) Simple Form … (English) (PDF 89 KB) or Simple Form (Spanish) (PDF 86 KB), which are simple PDF files that people … can print out and use a hard copy, or (2) Fillable Form (English) (PDF 1,001 KB) or Fillable Form

56. sbd4.PDF (pdf file)
    meps.ahrq.gov/survey_comp/misc_survey/mpc/1996/sbd4.pdf
    January 01, 1996 - BATCH: REGION: EVENT DATE: _____/_____/_____ (to _____/_____/_____) # OF EVENTS IN BOOKLET _____ FORM … ______ OF ______ MEDICAL EXPENDITURE PANEL SURVEY MEDICAL PROVIDER SURVEY MEDICAL EVENT FORM FOR … .. 1 NO, NEED TO COVER ADDITIONAL EVENTS............................................... 2 (NEXT FORM

57. AHRQ Statistical Brief 526 (pdf file)
    meps.ahrq.gov/data_files/publications/st526/stat526.pdf
    October 01, 2019 - Page does not require timed responses Navigation links Passed Navigation links are not repetitive Forms … Rule Name Status Description Tagged form fields Passed All form fields are tagged Field descriptions … Passed All form fields have description Alternate Text Rule Name Status Description Figures alternate

58. AHRQ Statistical Brief 524 (pdf file)
    meps.ahrq.gov/data_files/publications/st524/stat524.pdf
    July 01, 2019 - Page does not require timed responses Navigation links Passed Navigation links are not repetitive Forms … Rule Name Status Description Tagged form fields Passed All form fields are tagged Field descriptions … Passed All form fields have description Alternate Text Rule Name Status Description Figures alternate

59. Sam-Fac3 (pdf file)
    meps.ahrq.gov/data_stats/nhc/sam-fac3.pdf
    September 30, 1997 - In SS2, it becomes part of a form, for interviewer confirmation. … As cursor moves through the entry fields, display appropriate question text above the form. … SS24 Display as an overlay on the form. SS24 On what date did {SP} die? PROBE FOR MONTH. … Name of person completing form: PLEASE PRINT Title: Date form completed: ASSURANCE OF CONFIDENTIALITY … Name of person completing form: PLEASE PRINT Title: Date form completed: ASSURANCE OF CONFIDENTIALITY

60. Sam-Fac2 (pdf file)
    meps.ahrq.gov/data_stats/nhc/sam-fac2.pdf
    September 30, 1997 - The names are recorded on a paper form (the Facility Records Organization Grid or FROG). … In SS2, it becomes part of a form, for interviewer confirmation. … SHOW RATE FORM TO R. INDICATE RESULTS HERE. … LEFT RATE FORM WITH R TO PICK UP LATER TODAY . . 1 LEFT RATE FORM WITH R, CAN’T COMPLETE TODAY; RECORD … If Rate Form is not receipted in house, flag for data retrieval in next round.