PROCESS MANAGER
PROVIDER NOTIFICATION
AUDITING 101
WEBSITE KNOW HOW
DO YOU EXCEL?
100

How many days is provided for a new provider application to be reviewed and training completed?

15 business days

100

What amount of time is the provider given to submit their desk review documents?

Three

100

Name the reports that the QA Specialist pulls prior to beginning an audit.

Criminal History

Functional Ability

Survey

100

What is the name of the company that has approved training modules?

In The Know

100

The Provider Review Roster is sent with what columns hidden?

QAS Review

200

What effective date do I use for a RALF application?

  1. The date we approve the application (unless approved otherwise by QA Manager)
200

What notices are sent to the provider for a review?

QA Review Notice

Desk Review Instruction

Roster 

200

Name the % of participants and staff that must be audited?

30% or a minimum of 15 for participants

50% of a minimum of 15 for staff (only those new hires for the previous 2 years)

200

Name the three website pages of provider information 

1.  Providers

2.  Provider Training

3.  Provider Forms

200

What 2 ways can you enter information into the spreadsheet?

1.  Manually type it

2.  Select from a dropdown menu

300

What do I do with a CFH application?

Reject with a  note to DXC to route to DDSCentral queue for review. Or we can route it to DDSCentral.

300

How many weeks does a provider have to remediate any deficient review findings?

Three

300

Name the new audit element added for 2019 that ensures caregivers are knowledgeable in service delivery

Training Curriculums

300

Name 3 forms available to providers on the website

Agency Change, RN Supervisor, Change of Address, Non Use of Services, Notification of Change, Significant Change, Service and Provider Choice, UAI, Progress Notes, Exception

300

How should the QAS ensure the integrity of the data on the spreadsheet?

Password Protect it
400

Why does an existing provider have a new application in the queue?

DXC may need to assign an Atypical provider number or the provider is trying to add a Service Location

400

What happens if a provider does not respond to the Provider Review notification?

Payment Hold

400

How often is the caregiver required to narrate on a clients condition on the Progress Notes?

Daily is perfect, weekly is acceptable
400

How many Provider Help Aids are available on the website?

Eight

400

What is the name of an error value

#VALUE!

500

What is Region 9?

Out of state provider (or parent office)

500

Name 2 of the questions the providers must answer on the Key Survey? (excluding demographics)

There is only ONE question

In the last 12 months did you experience a significant time lag in receiving authorizations for participant services after an assessment had been completed?

500

What are the three ratings on the Review Findings?

Meets Requirements

Improvement Recommended

Requirements not met

500

Name 4 of the Help Aids available to providers?

Electronic Progress Notes, Assessment Score, Service Plan, QA and RN Oversight, Supervision, Companion, Night Needs, Online Training Modules

500

What concoctions allow data to auto populate into cells within an Excel spreadsheet?

Formula's

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