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Extra Services Request for Payment Form Alabama A&M University

Extra Services Request for Payment Form Alabama A&M University

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hi I'm going to guide you through how to best fill out the CD pH 609 form this form is used for initial change of ownership or report of change applications it allows the centralized application branch analyst to see what beds or services your hospital will like to add delete or modify the first section of the form is intended to identify the name of the facility type of the facility such as general acute care hospital or acute psychiatric hospital and the facility address the second section is designed to list the existing beds in the facility and the requested beds for example if the hospital currently has only 50 perinatal beds and a hundred unspecified general acute care beds then you will mark 50 perineal beds and 100 unspecified general acute care beds on the left side under the existing bed section the requested bed section is intended to show at beds the facility would like to change for example if you would like to add two pediatric beds you would list a two next to th

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