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Face To Face Encounter for Home Care
More Information
| Brand
| Sage |
| MPN
| 3401P-15 |
| Packaging
| 1 per each |
| Size
| 8-1/2In x 11In |
- Used to capture the information needed to meet the new CMS face to face visit requirements
- Includes qualifying encounter type
- Physician Attestation including clinical findings in the physician s own words
- 2-part form allows you to keep a temporary copy while the original is out for physician completion
UPDATED 2015
| Color: | Part 1: White, Part 2: Canary (Black Ink) |
| Size: | 8-1/2" x 11" |
| Hole Punch: | 5 holes on top and left side |
| Printed: | 1 side |
| Quantity: | 100 ea/pk (Also sold in a case of 20 pk/ca) |
