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Instructions for Form F-01017 Verbal Orders for Recertification: Home Health Agency Request for Variance of Physician Signature Requirement - Wisconsin
This document contains official instructions for Form F-01017 , Verbal Orders for Recertification: Request for Variance of Physician Signature Requirement - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-01017 is available for download through this link.
FAQ
Q: What is Form F-01017?
A: Form F-01017 is a document used in Wisconsin for verbal orders recertification in home health agencies.
Q: What is the purpose of Form F-01017?
A: Form F-01017 is used to request a variance to the physician signature requirement for home health agency recertification in Wisconsin.
Q: Who needs to use Form F-01017?
A: Home health agencies in Wisconsin who want to request a variance to the physician signature requirement for recertification.
Q: What does the form require?
A: The form requires information about the home health agency, client, physician, and the justification for requesting the variance.
Q: Are there any fees associated with submitting Form F-01017?
A: No, there are no fees associated with submitting Form F-01017.
Q: How should Form F-01017 be submitted?
A: Form F-01017 should be submitted to the agency's regional home health agency office.
Q: What happens after Form F-01017 is submitted?
A: The agency's regional home health agency office will review the form and notify the home health agency of the decision regarding the variance request.
Q: Is there a deadline for submitting Form F-01017?
A: There is no specific deadline mentioned for submitting Form F-01017, but it is recommended to submit the form in a timely manner to ensure it is processed before the recertification deadline.
Instruction Details:
- This 1-page document is available for download in PDF;
- Actual and applicable for the current year;
- Complete, printable, and free.
Download your copy of the instructions by clicking the link below or browse hundreds of other forms in our library of forms released by the Wisconsin Department of Health Services.
