Attestation Training Form

Form Template

Organizations and companies can attest that it has conducted appropriate education and training to identify, correct and prevent potential fraud, waste and abuse, as required by the final rule issued in the Federal Register for 42 CFR parts 422 and 423 of the Medicare Program.

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Language: English
Country: United States of America

Sign to attest that your organization has completed appropriate education and training to identify, correct and prevent potential fraud, waste, and abuse, and your organization will furnish upon request to FHCP training logs to validate that training was completed. The Attestation Training Form mobile app allows you to replace your paper attestation form with an Android, iPhone, tablet or Windows desktop computer. The mobile form includes fields to document items such as the name of the organization, training information, tax ID, address and captures a signature. Once the mobile app is filled out a secure PDF is generated. The PDF is easy to share, and a copy is stored in your account for your human resources records. You can also use the App Builder to personalize and customize this mobile form.

  • Signature Capture
  • Submission Editing
  • Reference Data
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  • iPhone
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  • Android
  • Windows
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  • Quickbooks
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