Required Documents
Job Aid
Leveraging
Miscellaneous 1
Miscellaneous 2
100

This document cannot have abbreviations 

What is the Roster/Org Chart/Ack form

100

PDC stands for? 

What is Payment Denial Codes? 

100

What leverage spreadsheet has 11 digits in the TIN 

What is HCBS?

100

Site Visit Coordinators are not permitted to contact this area regarding audits

What is QA?

100

Timeframe to submit hours into PPM 

What is Daily? 

200

This information is collected from the Business office file for a host/group home provider 

What is Required Documents?

200

This is utilized for safety concerns, inappropriate conduct, irate providers, etc.

What is Site Visit Coordinator Incident Report Form?

200

This field must always be entered as PASS on the SV form when leveraging 

What is Site Visit Results ?

200

The process for reporting unsafe environment/incidents during a visit

What is text "Conducting a Site Visit" to Leadership and excuse yourself from the visit? 

200

Timeframe for submitting Mileage Report

What is Weekly?

300

This document must refer patients to HHSC, OIG or Licensing Board

What is the Complaint Policy

300

These two items must be completed electronically when conducting the visits

What is Site Visit Form and Acknowledgement Form?

300

This would not need to be done if Site Visit is Leveraged with HCBS. 

What is LTCR? 

300

This is the allotted time to submit a dispute

What is in 24 hours?

300

This should be documented in all PC tickets 

What is all communication correspondence? 
400

This document is not needed if inactive or historical in PEMS

What is a Provider License 

400

You must do these three things if no one is available at the Site Visit location when you arrive?

What is while at the location, call the POC in PEMS, take a photo of the exterior of the home and ping/call Leadership?

400

To leverage LTCR visit the date of Survey must be within this timeframe.

What is one year of the current date?

400

This is required in outlook after scheduling a visit. 

What is the scheduled site visit? 

400

This should be entered if you notice that the name on any of the documents is different from the name of the enrolling provider? 

What is a note?

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