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Upper Midwest Fistula First Coalition

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1. Are we supposed to verify every HIC, SSN, start date, etc. and correct as necessary?
2. Are we supposed to verify each patient address listed?
3. Do all of the correct MD's need to be filled in?
4. How do I report changes?
5. When do I have to return an updated census to Network 11?

Answers

1. Are we supposed to verify every HIC, SSN, start date, etc. and correct as necessary?
   Answer: The main purpose of this form is to verify that no patient events have been missed. If you have the time to verify each data item, we encourage you to do so.
2. Are we supposed to verify each patient address listed?
   Answer: CMS requires a quarterly census with patient addresses be sent to facilities once each year. Please confirm addresses listed are correct. If there are missing addresses, please send a Patient Change of Address form to the Network 11 office.
3. Do all of the correct MD's need to be filled in?
   Answer: No.
4. How do I report changes?
   Answer: The census is for your records only; please do NOT return it to the Network office. If you have changes to report, submit them via the following month’s PAR (due to Network 11 on the 10 th of each month), or submit a Patient Change of Address form.
5. When do I have to return an updated census to Network 11?
   Answer: The census is for your records only; please do NOT return it to the Network office. If you have changes, see question 4 for instruction on when to submit and how.