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On this page, you will find various forms that Military Health System uses to support its programs. Please scroll down the page or use the search box to find specific forms and templates.
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Use this review worksheet to help establish a consistent UBO billing submission framework.
Use this template to develop your memorandum to create a UBO Compliance Plan.
Use this sample charter to develop the Compliance Committee Charter for your MTF.
Use this review worksheet to help establish a consistent UBO billing submission framework.
Use this review worksheet to help establish a consistent UBO billing submission framework.
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the AHLTA-Theater/AHLTA-Mobile/Mobile Computing Capability (AHLTA-T/AHLTA-M/MCC) system.
This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Coding and Compliance Editor (CCE) system.
UFBPA Appendix for the Nov 2015 DOD P&T Meeting for Namenda XR
UFBPA Appendix for the Nov 2015 DOD P&T Meeting for GI-2 Agents, Miscellaneous
UFBPA Appendix for the Nov 2015 DOD P&T Meeting for ADHD Stimulants
UFBPA Appendix for the Nov 2015 DOD P&T Meeting for Namzaric
UFBPA Appendix for the Nov 2015 DOD P&T Meeting for Acne Isotretinoids
UFBPA Appendix for the Nov 2015 DOD P&T Meeting for Antirheumatics Injectable Methotrexate
This form is required for all users to complete prior to receiving access to the Patient Encounter and Reporting (PEPR) application.
This Air Force Medical Support Agency (AFMSA) Privacy Impact Assessment (PIA) summarizes the RxSafe RxVault system.
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