1. 855 application submitted and approved by the ASC’s Fiscal Intermediary.
2. CMS 377 form completed and submitted to HSS.
3. CMS 370 completed in triplicate (each form must have original signatures) and submitted to HSS.
4. All licensed ASC facilities seeking initial Medicare certification must apply to one of the following accreditation organizations for an "initial deemed status Medicare survey" :
a. TJC - The Joint Commission
b. AAAHC - Accreditation Association of Ambulatory Care
c. AAAASF - American Association for the Accreditation of Ambulatory Surgery Facilities, Inc.
d. AOA - American Osteopathic Association
5. After the initial deemed status Medicare survey has been completed, DHH - HSS must receive a copy of the "deemed status" award letter.