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This version of the form is not currently in use and is provided for reference only. Download this version of
Form 377
for the current year.
Form 377 Patient-Centered Medical Home (Pcmh) Recognition Attestation Form - Alabama
What Is Form 377?
This is a legal form that was released by the Alabama Medicaid Agency - a government authority operating within Alabama. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the Form 377 Patient-Centered Medical Home (PCMH) Recognition Attestation Form?
A: Form 377 is a document used in Alabama to attest to the recognition of a Patient-Centered Medical Home (PCMH).
Q: What is a Patient-Centered Medical Home (PCMH)?
A: A Patient-Centered Medical Home (PCMH) is a primary care model that provides comprehensive, coordinated, and patient-centered care.
Q: Who can complete the Form 377?
A: The Form 377 can be completed by the primary care practice seeking recognition as a Patient-Centered Medical Home (PCMH).
Q: What information is required on the Form 377?
A: The form requires general practice information, contact details, and attestation to meeting the PCMH recognition requirements.
Q: Is the Form 377 specific to Alabama?
A: Yes, the Form 377 is specific to Alabama and is used for PCMH recognition attestation in the state.
Q: Can a practice be recognized as a PCMH without completing the Form 377?
A: No, completing the Form 377 is typically required to attest to the PCMH recognition in Alabama.
Q: What are the benefits of becoming a recognized PCMH?
A: Becoming a recognized PCMH can lead to improved patient care, increased reimbursement, and enhanced care coordination.
Q: Are there any fees associated with PCMH recognition?
A: There may be fees associated with PCMH recognition, including application fees and ongoing maintenance fees.
Q: What is the purpose of PCMH recognition?
A: PCMH recognition aims to promote high-quality, patient-centered primary care and improve health outcomes for patients.
Form Details:
- Released on January 1, 2023;
- The latest edition provided by the Alabama Medicaid Agency;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form 377 by clicking the link below or browse more documents and templates provided by the Alabama Medicaid Agency.
