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[DOC File]Ambulatory Surgical Center Section II
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210.200 Definition, Scope and Coverage of Ambulatory Surgical Center (ASC) Services 7-1-14 A. An ASC is a distinct entity that operates exclusively to furnish outpatient surgical services to patients not requiring hospitalization. 1. Certain surgical or medical procedures may require prior authorization. 2.

[DOC File]Ambulatory Surgical Center Section II
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210.200 Definition, Scope and Coverage of Ambulatory Surgical Center (ASC) Services 7-1-14 A. An ASC is a distinct entity that operates exclusively to furnish outpatient surgical services to patients not requiring hospitalization. 1. Certain surgical or medical procedures may require prior authorization. 2.

[DOC File]«FACILITY»
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AMBULATORY SURGICAL FACILITY . LICENSE RENEWAL APPLICATION. ... Enter the number of the top 20 common imaging procedures performed in the ambulatory surgical center in the table below by CPT code. ... This license renewal application must be completed and submitted to the Acute and Home Care Licensure and Certification Section, Division of ...

[DOC File]Chapter 246-330 WAC: Ambulatory Surgical Facility ...
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An ambulatory surgical facility must comply with chapter 70.230 RCW and this chapter; An ambulatory surgical facility certified by the Centers for Medicare and Medicaid Services or accredited by the Joint Commission, Accreditation Association for Ambulatory Health Care or American Association for Accreditation of Ambulatory Surgery Facilities must:

[DOC File]Licensure & Certification Application
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AMBULATORY SURGICAL CENTER. LICENSE APPLICATION. Fees: Initials, Change in Ownership, Annual Renewal (Anything marked in 1a thru 1c below) $100 Changes (Anything marked in 1d thru 1e below) $50 Make Payment to: Treasurer, State of Wyoming FOR HLS USE ONLY Fee Paid Old # Appl Approved Check # New #

CHAPTER 59A-5 AMBULATORY SURGICAL CENTER LICENSURE
Complaints involving any ambulatory surgical center shall be reviewed and sent to the appropriate agency’s local area health facility regulation office for investigation, if it is determined that the allegations could constitute a violation of state licensure and federal certification;

[DOC File]Notification Requirements for Determination of CON ...
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Notification Requirements for a Determination of Coverage for . Ambulatory Surgical Capacity in a Freestanding Setting . Establishing an ambulatory surgery center or facility, as defined in statute at Health-General Article §19-114, requires prior written approval from the Maryland Health Care Commission (“MHCC” or …

Supporting Statement for Ambulatory Surgical Center
CMS-377 -- Ambulatory Surgical Center (ASC) Request for Certification or Update of Certification Information. CMS-378 -- ASC Survey Report Form. OMB 0938-0266. A. Background. CMS-370 Health Insurance Benefits Agreement. This form is utilized for the purpose of establishing eligibility for payment under Title XVIII of the Social Security Act ...

[DOC File]Licensure & Certification Application
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AMBULATORY SURGICAL CENTER. LICENSE APPLICATION INSTRUCTIONS. FOR ANNUAL RENEWAL. Important Information: The renewal application is a Word fillable form and must be used in print layout view. Tab through the application form to advance in the document. Each facility type must be submitted on the appropriate renewal application.

Ambulatory surgical center certification