Required Documentation

Required Documentation

As a provider you are required to maintain documentation to ensure your continued certification. Below are a SOME of the required documentation for a provider. Depending on your certification your requirements may be different. If you have questions please contact Muskingum DD Provider Support staff at [email protected]

HPC AND SHARED LIVING DOCUMENTATION FORMS:

Documentation Form: Per DODD rule and Medicaid Requirements you will need to complete a daily documentation sheet. Linked is a form that has all of the DODD required elements. You will find the “description of services” that you are responsible for throughout the ISP. There is also a space to document your responsibilities associated with the Individual’s Outcome.

TRANSPORTATION FORM:

As an HPC or Shared Living Provider: If you provide residential transportation you must complete transportation documentation. 

ACTION PLAN(S) & LEARNING LOGS:

Should be completed according to the frequency listed in ISP.  If unsure of required frequency contact the SSA.

Documenting Time and Units of Service:
                                                  
Must include the number of units of the delivered service or continuous amount of uninterrupted time during which the service was provided. Times the delivered service started and stopped.

MUI ANALYSIS FORMS:

MUI Analysis Form will need to be completed annually in January.

UNUSUAL INCIDENT LOG:

Unusual Incident Log Review Form- Must be completed monthly even if there are no Unusual Incident Reports that month.

UNUSUAL INCIDENT FORM:

This form is to be used when something unusual happens in a person’s life.

BILLING AND SERVICE DOCUMENTATION TRAINING:

This is a requirement for all providers and must be completed within 60 days of initial certification. It is located on the DODD website through “My Learning”.

EVV REQUIREMENTS:

Providers of HPC services are required to use EVV to clock in and out and record their times of service. Electronic Visit Verification, or EVV, is a requirement under the 21st Century Cures Act, a federal law passed in December of 2016. Under the 21st Century Cures Act, states must implement an electronic system to verify certain home and community-based services were delivered in order to continue receiving federal financial support toward the costs of those services.
*Shared Living Providers are not required to use EVV

Find out more at
https://dodd.ohio.gov/providers/billing/Electronic%20Visit%20Verification%20(EVV)
5123-9-06 Providers of home and community-based services shall maintain the records necessary and in such form to disclose fully the extent of home and community based services provided, for a period of six years from the date of receipt of payment or until an initiated audit is resolved, whichever is longer. The records shall be made available upon request to the department, the Ohio department of Medicaid, the centers for Medicare and Medicaid services, and/or the auditor of state. Providers who fail to produce the records requested within thirty calendar days following the request shall be subject to denial, suspension, or revocation of certification and/or loss of their Medicaid provider agreement. 

Disclaimer: These are not official documents, and there is no requirement that providers use these particular documents, nor is there any guarantee that this form will be in compliance with later rules. It remains the responsibility of the provider to be familiar with all applicable rules, including those covering service delivery and documentation. Use of these forms for documentation is not a guarantee of payment, and services must be provided before claims are submitted for reimbursement. We make every effort to ensure the information on this page is accurate and up to date, however changes occur often at the state level. While we are diligent in keeping our website up to date, please see dodd.ohio.gov for the latest information.
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