Team Aleman Jeopardy

Audit Errors

100

Is OnBase labeling a requirement?

OnBase labeling is required.

1. OnBase Documentation
   • If the document cannot be viewed through OnBase due to either an encryption or password protection, mark as a deficiency. Provider must upload document without encryption

10. For Provider Screenings attachments, correctly label the Keyword field in OnBase for the provider and OCPs:
    • Provider Last Name/Org Name: Enter the Last or Legal Name Searched in Provider Screenings as appl

200

If the Medicare ID is end dated in the Reassignment of Benefits section of the PECOS report and not end dated under Medicare ID section, is a deficiency needed? 

Yes, the Medicare ID needs to be active in both locations. 

300

Can a Performing Provider enroll in a Groups Practice Location that is disenrolled? 

No, they cannot enroll in a disenrolled practice location.  

• If the Group’s practice location has a Disenrolled status or
• If the program the Performing Provider is enrolling into has a Disenrolled status
  • Mark the deficiency and include the response criteria required to satisfy the deficiency

400

Can an alias be used to validate a name on the PECOS report? 

No, it can only be used for name variation on the license. 

A.) Medicare and License Required: If provider has at least one enrolled/pending enrollment practice location + program combination where the requirements include Medicare and a professional healthcare license:

• First and Last name fields must match:
  • PECOS, and
  • License
    • Variations between the First and Last Names on the License and Medicare are acceptable, as long as:
      • The name variation on the license is listed in the Maiden Name, Other Alias, Nicknames section
      • The First and Last Name fields still match what is provided on the Agreement

500

A def is required to be sent when a Site Visit Rework Note is present in the Notes section of Request Management page?

Yes, a deficiency is required to be sent.

Note: This has been sent as an audit, but it can be disputed since there is no real direction in wikis.

License/Certifications

100

For Certification/License that is not required, what action needs to be taken on the program and services participation page for certifications/license that are not required.

If the provider record includes a certification that is not required to be stored in PEMS for the provider type under which they are enrolling, e.g. A certification whose Issuer has been changed to Other:

• Click the ellipses (...)
• Select Remove
• Click Save
• Note: Selecting Remove on a previously approved segment will only add an end date to the association effective date. Only newly added segments can be removed from the License/Certification/Accreditations table on the Program and Services Participation page.

200

For Multiple RN licenses with same number, we would use the most current effective date. 

False, combine the information from both sources and default the Effective Date with the earliest Original Issue Date and default with the most current Expiration Date. 

300

Does the Disclosure section (Public Actions Information) for Dental License need to be visible on the license screening?  

Yes, whole license needs to be captured. Although wiki does not fully include this information, it is a requirement. 

400

For CRNA License effective date is the Initial Certification Date used, or the Current Certification Period date used? 

Individual and Performing Providers must be certified by the National Board of Certification and Recertification for Nurse Anesthetist or The Council on Accreditation of Nurse Anesthesia.

• Use the Initial Certification Date as the Effective Date
• Select Texas as the State Issuer

500

If the provider is enrolling as a Physician Assistant is a Supervising Physician License (SPL) information required? 

The SPL license information is needed, and the License needs to be uploaded to OnBase 

1. The provider must disclose a supervising physician license number with the effective and termination date and that is licensed by the appropriate state board where services are rendered.
   1. The Supervising Practitioner's License (SPL) must be active during enrollment.
      1. For In-state Providers: verify from the TX Medical Board
      2. For Out-Of-State Providers: see License board website list for Online Verification to identify the appropriate OOS Board website.
   2. For Individual enrollments, Confirm Supervising Physician is listed within the Owner/Creditors/Principals section
   3. For Performing Provider enrollments, confirm the Supervising Physician is listed within the Program and Service Participation Details subpage

True or False

100

The Deficiency History tab is located in the Submission History Page 

False, it is found in the Request Management Page  

200

LMS and Accenture Trainings are required to maintain compliance for access. 

True, to maintain login access trainings are required. 

300

When working any applications the Special Handling will always need to be selected either with Yes or No

True, the Special Handling question will always need to be selected. 

400

A provider can enroll in CSHCN only

False, the provider must be actively enrolled in Acute Care Services

500

All screenings must have a status—such as “Application Not Required,” “Verification Complete,” or “Manually Completed”—before submitting an application.

True, a status is always required. 

Ensure the Status field has a status of Verification Complete or Manually Completed. A status of Not Required is only acceptable for duplicate screening records.

> Click here to review statuses that are not valid:

• Blank
• Pending
• Unable to Process

Misc

100

Timeframe to submit hours into PPM

Daily 

200

Where can Team Aleman Resources spreadsheet be found? 

In Main Team Aleman Teams Chat

300

Is it required to call the attendance line if I am running more than 10 minutes late? 

• Notes are required for any time discrepancies. As our team grows, this helps me quickly identify issues without reviewing every individual entry.
• If you will be late arriving in the morning or late returning from lunch by more than 10 minutes, you must call the attendance line.

400

Are emails needing to be sent to dispatch at this time to notify when out of tickets? 

No currently we are not sending an email to dispatch. However, we are to notify Chrissy and Mason. 

500

If HTW is not end dated for end of 2026 does this need to be escalated to PSBAT? 

Yes, this needs to be escalated to PSBAT using the Error Code Troubleshooting Wiki

If the expiration date is not the last day of the current year or the upcoming year, refer to the Error Code Troubleshooting work instructions.