Provider Compliance Review

There are various reasons providers do not respond to the 90-day Provider Compliance Review Notification.  
 

1. The provider's email is not up to date in PCW - therefore they are not receiving the notification.    

             *attempt a contact via phone and see the non-responsive provider process (777) below

2. The provider has trouble getting onto the provider portal to input their delegate

  1. Have the provider contact by email Erica Barrett-Morrison or by phone at 1 (614) 902-4249 - don't hesitate - get the provider assistance before they are frustrated and upset

3. The provider is avoiding the review 

  • Follow the non-responsive provider process (777) below reviews that are suspended in RDS and are to be sent to OPSR for possible suspension or proposed revocation. When a review suspends the county board group manager for that review is notified. OPSR group managers are not notified.  Here is a reminder of the 777 process in RDS.

Reviews that are suspended in RDS and are to be sent to OPSR for possible suspension or proposed revocation. When a review suspends the county board group manager for that review is notified. OPSR group managers are not notified

Here is a reminder of the 777 process in RDS.

  •                           Non-Responsive Provider - 777 process in RDS

    • RDS sends the initial notification to the provider and the provider has 14 days to respond.  If no response
    • In 7 days RDS will send reminder #1 - day 21
    • Once the email is sent the reviewer must call the provider to follow up and document the call in the notes section of RDS.  
    • In 7 days RDS will send reminder #2 - day 28
    • Once the email is sent the reviewer must call the provider to follow up and document the call in the notes section of RDS.  
    • In 7 days RDS will send reminder #3- day 35
    • Once the email is sent the reviewer must call the provider to follow up and document the call in the notes section of RDS.
    • In 7 days RDS will send the Final Notification - day 42
    • The provider must respond by day 49
    • At this point RDS will send a notice that the review should be sent to OPSR for Sanctions. Please notify one of the OPSR Managers

    How to enter 777 into RDS

    Activities Show the Emails Sent by RDS

    Screenshot from Review Communication Activity page

    Document phone calls into NOTES Section

    Screenshot that shoes where phone calls can be documented into NOTES section

    If the provider has not responded to the review notifications and phone calls after all attempts are made, the Group Manager must send the information to Vanessa Prather or Kristi Williams with an explanation: 

    •    Provider relinquished,
    •    Provider never responded,
    •    All attempts were completed,
    •    Provider had trouble with the Provider Portal,
    •    Provider tried to cooperate but system issues did not get them on the portal before the review suspended..
    •    Provider certification expired
    •    Other issues as they apply

      NOTE:  IF THE PROVIDER IS HAVING PROBLEMS WITH THE PROVIDER PORTAL HAVE THEM CONTACT 

    ERICA.BARRETT-MORRISON@DODD.OHIO.GOV OR VIA PHONE AT 614.466.6670.

     

    Provide the status of your reviews to  Kristi.Williams@dodd.ohio.gov or Vanessa.Prather@dodd.ohio.gov

     

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