Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Claims Denial Disclosure under MHPAEA Modified 6198477 63795 0
Disclosure Request Form Modified 191385 15949 0 Form and Instruction CMS-10307
Form and Instruction CMS-10307
Form and Instruction CMS-10307
Form and Instruction CMS-10307
Form and Instruction CMS-10307
Form and Instruction CMS-10307
Form and Instruction CMS-10307
Form and Instruction CMS-10307
Form and Instruction CMS-10307
Medical Necessity Disclosure under MHPAEA Modified 93090 7674 0
Medical Necessity Disclosure under MHPAEA sent with Claims Denial Disclosure Modified 61985 6379 0
Total burden requested under this ICR: 6544937 93797 0  
To view an IC, click on IC Title