ICR Documents

Supporting Statement A

Document	Date Uploaded
Supporting Statement Part A -- Clean.docx	11/07/2019

Supporting Statement B

Document	Date Uploaded
Supporting Statement Part B -- Clean.docx	11/07/2019

Supplementary Documents

Title	Document	Document Type	Date Uploaded
Attachment 1 – MEPS-HC Section Summary and Changes	Attachment 1 final draft.09052018..docx	Supplementary Document	09/12/2018
Attachment 2 – HC Why is Participation in MEPS so Important?	Attachment 2 HC Why is Participation in MEPS so Important.pdf	Supplementary Document	09/12/2018
Attachment 3 – HC MEPS: A Survey of Health Care Use and Spending	Attachment 3 HC MEPS A Survey of Health Care Use and Spending.pdf	Supplementary Document	09/12/2018
Attachment 4 – HC What MEPS tells us about…Charts	Attachment 4 HC What MEPS tells us about Charts.docx	Supplementary Document	09/12/2018
Attachment 5 – HC About the MEPS-MPC Authorization Form	Attachment 5 HC About the MEPS MPC Authorization form.pdf	Supplementary Document	09/12/2018
Attachment 6 – HC Data protection is word ONE with MEPS	Attachment 6 HC Data Protection is word ONE with MEPS.pdf	Supplementary Document	09/12/2018
Attachment 7 – HC Respondent Recruitment Video	Attachment 7 HC Respondent Recruitment Video Transcript.pdf	Supplementary Document	09/12/2018
Attachment 8 – HC Important Information About Your Participation in MEPS	Attachment 8 HC Important Information About Your Participation in MEPS.pdf	Supplementary Document	09/12/2018
Attachment 9 – HC MEPS Data Example & FAQs	Attachment 9 HC Data Example and FAQs.docx	Supplementary Document	09/12/2018
Attachment 10 – HC Respondent Letters, Postcards and Notes	Attachment 10 HC Respondent Letters, Postcards and Notes.docx	Supplementary Document	09/12/2018
Attachment 11 – HC MEPS FAQs Brochure	Attachment 11 HC MEPS FAQs Brochure.pdf	Supplementary Document	09/12/2018
Attachment 12 – HC MEPS Monthly Planner	Attachment 12 HC MEPS Monthly Planner.pdf	Supplementary Document	09/12/2018
Attachment 13 – HC MEPS Record Keeper	Attachment 13 HC MEPS Record Keeper.pdf	Supplementary Document	09/12/2018
Attachment 14 – HC Showcards	Attachment 14 HC Showcards.pdf	Supplementary Document	09/12/2018
Attachment 15 – HC Validation Letter	Attachment 15 HC Validation Letter.pdf	Supplementary Document	09/12/2018
Attachment 16 – HC Certificate of Appreciation	Attachment 16 HC Certificate of Appreciation.pdf	Supplementary Document	09/12/2018
Attachment 17 – HC Who Uses MEPS Data	Attachment 17 HC Who Uses MEPS Data.pdf	Supplementary Document	09/12/2018
Attachment 27 – HC MEPS Tip Sheet	Attachment 27 HC MEPS Tip Sheet.pdf	Supplementary Document	09/12/2018
Attachment 28 – HC Tips for Making Your MEPS Interview Easier	Attachment 28 HC Tips for Making Your MEPS Interview Easier.pdf	Supplementary Document	09/12/2018
Attachment 79 – MPC Home Care Provider Authorization Form Package, Phone Data Collection Anticipated	Attachment 79 – MPC Home Care Provider Authorization Form Package, Phone Data Collection Anticipated.doc	Supplementary Document	09/12/2018
Attachment 80 – MPC Home Care Provider Authorization Form Package, Records to be provided via Fax Anticipated	Attachment 80 – MPC Home Care Provider Authorization Form Package, Records to be Provided via Fax Anticipated.doc	Supplementary Document	09/12/2018
Attachment 81 – MPC Home Care Provider Overflow Patient List	Attachment 81 – MPC Home Care Provider Overflow Patient List.docx	Supplementary Document	09/12/2018
Attachment 82 – MPC Home Care Provider Questionnaire for Non-Health Care Providers	Attachment 82 – MPC Home Care Provider Questionnaire for Non-Health Care Providers.docx	Supplementary Document	09/12/2018
Attachment 84 – MPC Office-Based Doctor Provider Authorization Form Package, Records to be provided via Fax Anticipated	Attachment 84 – MPC Office-Based Doctor Provider Authorization Form Package, Phone Data Collection Anticipated.doc	Supplementary Document	09/12/2018
Attachment 85 – MPC Office-Based Doctor Provider Authorization Form Package, Phone Data Collection Anticipated	Attachment 85 – MPC Separately Billing Doctor Provider Authorization Form Package, Phone Data Collection Anticipated.doc	Supplementary Document	09/12/2018
Attachment 86 – MPC Office-Based Doctor Provider Overflow Patient List	Attachment 86 – MPC Office-Based Doctor Provider Overflow Patient List.docx	Supplementary Document	09/12/2018
Attachment 88 – MPC Separately Billing Doctor Provider Authorization Form Package, Records to be provided via Fax Anticipated	Attachment 88 – MPC Hospital Provider Authorization Form Package,.doc	Supplementary Document	09/12/2018
Attachment 89 – MPC Separately Billing Doctor Provider Authorization Form Package, Phone Data Collection Anticipated	Attachment 89 – MPC Separately Billing Doctor Provider Authorization Form Package, Phone Data Collection Anticipated.doc	Supplementary Document	09/12/2018
Attachment 90 – MPC Separately Billing Doctor Provider Overflow Patient List	Attachment 90 – MPC Separately Billing Doctor Provider Overflow Patient List.docx	Supplementary Document	09/12/2018
Attachment 92 – MPC Hospital Provider Authorization Form Package, One Point of Contact for Medical and Patient Account Records	Attachment 92 – MPC Institution Provider Questionnaire.docx	Supplementary Document	09/12/2018
Attachment 93 – MPC Hospital Provider Authorization Form Package, Point of Contact for Medical Records	Attachment 93 – MPC Hospital Provider Authorization Form Package, Point of Contact for Medical Records.doc	Supplementary Document	09/12/2018
Attachment 94 – MPC Hospital Provider Authorization Form Package, Point of Contact for Patient Account Records	Attachment 94 – MPC Hospital Provider Authorization Form Package, Point of Contact for Patient Account Records.doc	Supplementary Document	09/12/2018
Attachment 95 – MPC Hospital Provider Overflow Patient List	Attachment 95 – MPC Hospital Provider Overflow Patient List.docx	Supplementary Document	09/12/2018
Attachment 97 – MPC Letters, Email Templates, and Other Documents	Attachment 97 – MPC Letters, Emal Templates, and Other Documents.docx	Supplementary Document	09/12/2018
Attachment 99 – MPC Pharmacy Provider Authorization Form Package, Records to be provided via Fax Anticipated	Attachment 99 – MPC Pharmacy Provider Authorization Form Package, Records to be Provided via Fax Anticipated.doc	Supplementary Document	09/12/2018
Attachment 100 – MPC Pharmacy Provider Authorization Form Package, Phone Data Collection Anticipated	Attachment 100 – MPC Pharmacy Provider Authorization Form Package, Phone Data Collection Anticipated.doc	Supplementary Document	09/12/2018
Attachment 101 – MPC Pharmacy Provider Overflow Patient List	Attachment 101 – MPC Pharmacy Provider Overflow Patient List.docx	Supplementary Document	09/12/2018
Attachment 102 – MPC Durable Medical Equipment Provider Authorization Form Package	Attachment 102 – MPC Durable Medical Equipment Provider Authorization Form Package.docx	Supplementary Document	09/12/2018
Attachment 103 – MPC Pharmacy Provider Letters, Email Templates, and Other Documents	Attachment 103 – MPC Pharmacy Provider Letters., Email Templates, and Other Documents.doc	Supplementary Document	09/12/2018
Attachment 104 – MPC Veterans Affairs Authorization Form Package	Attachment 104 – MPC Veterans Affairs Authorization Form Package.docx	Supplementary Document	09/12/2018
Response Letter to AANP	response Nurse Pract FRN Comment.msg	Supplementary Document	07/15/2019

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