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Patient-Provider Selected Dispute Resolution Entity Recertification

IC 253135 under ICR 202303-0938-013 · OMB 0938-1433.

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Patient-Provider Selected Dispute Resolution Entity Recertification
 
No Unchanged
 
Mandatory
 
45 CFR 149.620

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

1 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1 0 0 0 0 1
Annual IC Time Burden (Hours) 3 0 0 0 0 3
Annual IC Cost Burden (Dollars) 257 0 0 0 0 257

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