Is a pre-certification on-site review necessary if a provider agency has completed a full performance review within 12 months prior to application?
Probably not. Every provider agency certified by the Department must have a pre-certification on-site review. For current CCP providers, this requirement is met if a full performance review has been successfully completed within 12 months prior to the date of application. However, a pre-certification on-site review may be necessary if a provider that is subject to a pending contract action is not making satisfactory progress to resolve findings during the applicable timeframe for correction action. NOTE: The Department reserves the right to conduct a performance review of a contracted provider agency at any time during the course of the provider’s contract period.
Related Questions
- If an agency gives a summary performance rating when it does its mid-year review, can that rating be used for crediting performance in a reduction in force if it was given before the cut-off date?
- Can an insurance carrier make an on-site visit to a providers office and review/copy patient records? Is such an audit permitted without a Commissioner of Workers Compensation order?
- Is a pre-certification on-site review necessary if a provider agency has completed a full performance review within 12 months prior to application?
