ICR Documents

Supporting Statement A Document Date Uploaded Supporting Statement Part A -- MEPS SDOH SAQ and covid.after 30 day frn and sept 30 omb call.final 100820.v2.docx 11/17/2020 Supporting Statement B Document Date Uploaded Supporting Statement Part B -- MEPS SDOH SAQ and covid.after 30 day frn and sept 30 omb call.final 100820.docx 11/17/2020 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 Attachment A1 - MEPS New COVID-19 Delays in Receiving Care Items Crosswalk Attachment A1 - MEPS New COVID-19 Delays in Receiving Care Items Corsswalk.docx Supplementary Document 11/17/2020 Attachment D - MEPS New Social and Health Experiences SAQ Items Crosswalk Attachment D - MEPS New Social Determinates of Care SAQ Items Crosswalk v2.docx Supplementary Document 11/17/2020 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received