Acknowledgment / Certification Statement for a Hysterectomy - Colorado Medical Assistance Program - Colorado

Acknowledgment / Certification Statement for a Hysterectomy - Colorado Medical Assistance Program - Colorado

Acknowledgment/Certification Statement for a Hysterectomy - Colorado Medical Assistance Program is a legal document that was released by the Colorado Department of Health Care Policy and Financing - a government authority operating within Colorado.

FAQ

Q: What is the Hysterectomy Certification Statement?
A: The Hysterectomy Certification Statement is a document required for the Colorado Medical Assistance Program.

Q: What does the Hysterectomy Certification Statement certify?
A: The Hysterectomy Certification Statement certifies that a hysterectomy procedure is medically necessary.

Q: Why is the Hysterectomy Certification Statement required?
A: The Hysterectomy Certification Statement is required to ensure that Medicaid funds are used only for medically necessary procedures.

Q: Who needs to complete the Hysterectomy Certification Statement?
A: The Hysterectomy Certification Statement needs to be completed by the physician who performed the hysterectomy.

Q: How can I obtain the Hysterectomy Certification Statement form?
A: You can obtain the Hysterectomy Certification Statement form from the Colorado Medical Assistance Program.

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Form Details:

  • Released on November 1, 2017;
  • The latest edition currently provided by the Colorado Department of Health Care Policy and Financing;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Colorado Department of Health Care Policy and Financing.

Download Acknowledgment / Certification Statement for a Hysterectomy - Colorado Medical Assistance Program - Colorado

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