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Appendix E Informal Checklist
Pages 105-106

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From page 105...
... Admit ~ sag shee t Xerox of face sheet Ent ire record Discharge list: hand-wrst ten computerized Other typed 6. If portions of the medical record were transmitted, what was the training of the person in the billy ng 'office who determ: ned the diagnoses that should be entered on the Medicare claim form?
From page 106...
... (Please note whether physical therapy or other non-surg~cal procedures were secluded on the Medicare claims form.


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