Instructions For Schedule Em-C - Wisconsin Department Of Revenue - 2012
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3Instructions for 2012 Schedule EM-C
and to exchange and integrate electronic health
GENERAL INSTRUCTIONS
information with and from other sources.
Purpose of Schedule EM-C
"Health care provider" means any of the following
licensed under the Wisconsin statutes: nurse,
Use Schedule EM-C to request certification of
chiropractor, dentist, physician, physician assistant,
hardware and software expenditures made by a
perfusionist, respiratory care practitioner, physical
Wisconsin licensed health care provider to maintain
therapist,
podiatrist,
dietitian,
athletic
trainer,
medical records in electronic format. A claimant
occupational
therapist,
occupational
therapy
must be certified by the Wisconsin Department of
assistant, optometrist, pharmacist, acupuncturist,
Revenue (department) in order to claim the
psychologist, social worker, marriage and family
electronic medical records credit and the certification
therapist, professional counselor, speech-language
request must be submitted to the department by
pathologist,
audiologist,
massage
therapist,
January 31, 2013. By February 28, 2013 the
bodywork therapist, a partnership of any providers
department will notify claimants whether or not they
listed above, a corporation or limited liability
meet the certification requirements and the amount
company
of
any
providers
listed
above,
a
of credit the claimant is eligible for.
cooperative health care association that directly
provides services through salaried employees in its
How to File
own facility, a hospice, an inpatient health care
facility, a community-based residential facility, and a
To reduce errors, paperwork, and time, complete
rural medical center.
Schedule EM-C electronically from January 3
through January 31, 2013 through the department's
"Taxable year" means the taxable period on which
free online business tax system.
the taxable income of the taxpayer is computed for
federal income tax purposes. The taxable year of a
To e-file Schedule EM-C:
taxpayer who keeps his or her accounting records
•
on the basis of a 52-53 week period ends on the last
Go to
tap.revenue.wi.gov/services
•
day of the month closest to the end of the 52-53
Select "Submit Electronic Medical Records
week period.
Credit – Certification"
•
Enter your business information and confirm
SPECIFIC INSTRUCTIONS
the mailing address
•
Enter the qualified software purchased.
Amended Returns
You must have the CHPL number for your
software, provided by the
Office of the National
Claimants will be allowed to file an amended
Coordinator for Health Information Technology
Schedule EM-C from January 3, 2013 through
•
Enter the qualified hardware purchased
January 31, 2013.
No amended returns will be
•
Enter the preparer information and Submit
accepted after January 31, 2013. Check the box in
the upper right hand corner of the schedule if this is
Definitions
an amended return.
"Claimant" means a person who files a claim under
Section A:
Identifying number—Businesses that
this subsection.
have been issued a federal employee identification
number (FEIN) should enter the FEIN number in the
identifying number box; individuals not required to
"Electronic medical record" means an electronic
obtain a FEIN should enter their social security
record of health-related information that includes
number.
patient demographic and clinical health information
and has the capacity to provide clinical decision
Section B: Provide the product name and version
support; to support physician order entry; to capture
number of the information technology software used
and query information relevant to health care quality;
to maintain the electronic medical records, the
federal
CHPL
(Certified
Health
Information
IC-172CRT
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