This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is HCA12-200 Other Provider Preventable Conditions (Oppc) Notification Form?
A: HCA12-200 is a form used in Washington for reporting Other Provider Preventable Conditions (Oppc).
Q: Who needs to fill out the HCA12-200 form?
A: Healthcare providers in Washington who have identified an Other Provider Preventable Condition (Oppc) are required to fill out the HCA12-200 form.
Q: What are Other Provider Preventable Conditions (Oppc)?
A: Oppc refers to health care-associated conditions that are potentially preventable and not related to the primary reason for the patient's admission.
Q: What information is required on the HCA12-200 form?
A: The HCA12-200 form requires information about the patient, the health care provider, the condition or event, and steps taken to address and prevent future occurrences.
Q: Is there a deadline for submitting the HCA12-200 form?
A: Yes, healthcare providers are required to submit the HCA12-200 form within 30 days of identifying the Other Provider Preventable Condition (Oppc).
Form Details:
Download a printable version of Form HCA12-200 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.