Millennium Bill Emergency Care Provider Satisfaction Survey

ICR 200907-2900-010

OMB: 2900-0763

Federal Form Document

Forms and Documents
Document
Name
Status
Form
New
Supplementary Document
2011-02-01
Supplementary Document
2011-02-01
Supplementary Document
2011-02-01
Supporting Statement A
2009-12-08
Supporting Statement B
2009-12-08
Supplementary Document
2009-11-18
IC Document Collections
ICR Details
2900-0763 200907-2900-010
Historical Active
VA
Millennium Bill Emergency Care Provider Satisfaction Survey
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 02/25/2011
Retrieve Notice of Action (NOA) 12/08/2009
Approved consistent with revised VA materials.
  Inventory as of this Action Requested Previously Approved
02/28/2014 36 Months From Approved
110 0 0
9 0 0
0 0 0

In an effort to improve service delivery, reduce program costs, minimize payment errors and increase the timeliness of reimbursements to non-VA healthcare providers and Veterans, VHA Chief Business Office (CBO) has re engineered its end-to-end automated process for healthcare claims processing for claims from non-VA providers. CBO is evaluating the performance of the VA Financial Service Center (FSC), a franchise fund organization of the VA where non-VA claims processing efforts have been consolidated for two Veterans Integrated Service Networks (VISN.

US Code: 38 USC Part I, Chapter 5, Section 527 Name of Law: Evaluation and data collection
  
None

Not associated with rulemaking

  74 FR 173 09/09/2009
74 FR 220 11/17/2009
No

1
IC Title Form No. Form Name
Millennium Bill Emergency Care Provider Satisfaction Survey VA Form 10-0473 Millennium Bill Emergency Care Provider Satisfaction Survey

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 110 0 0 110 0 0
Annual Time Burden (Hours) 9 0 0 9 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new collection and all burden hours are considered a program increase.

$75,000
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Denise McLamb 202-565-8374 denise.mclamb@mail.va.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/08/2009


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