Riverbend

Forms

Use the below link to refer to Flash 04-05C for detailed information on cost report filing instructions. The cost report acceptability checklists, Sanction Certification Form, Provider Contact Memorandum and the CMS Form 339 are all a part of the Flash. Should you have any questions about this Flash you may contact either of the following:

Cindy Hauke, Audit Manager in the TN office (423) 535-3805

Cost Report Submission 

 

See Also:

• CMS links to form instructions