Final Letter of NO FINDINGS (PC042)
This letter is sent to the participating provider when there were no findings identified during the provider compliance review process. No further activities are required of the provider.
Cover Letter-Report on Provider Compliance Review WITH FINDINGS from County Board - for provider to respond (PC043)
For reviews conducted by the county boards, enclose with cover letter:
Provider Compliance Preliminary Report “Provider Acknowledgement” Form (PC044)
This form is sent with the PC Review-Preliminary Report. The Provider must send back the signed acknowledgement form to the review entity. The form must be checked as to whether the provider “concurs” or “does not concur” with the findings in the report. (Used for County Board reviews only.)
Provider Compliance Review Initial Report & Provider POC Response & Verification (PC045)
This is a COMBINED REPORT AND POC RESPONSE FORM. This form is also used by the Dept/County Board to verify provider POC responses.
Letter to Provider Re: CB Decision –(Support/Not Support) Written Objections from Provider (PC047)
This letter is sent to the provider if the provider has filed an objection to any of the findings in the preliminary compliance review report from the County Board. (See Acknowledgement Form.) This letter allows the County Board to (1) support the objection/s with a modified Report sent back or (2) not support the objections presented by the provider.
Request for State Appeal of County Board Review (PC048)
This form is completed by the provider when they disagree with a finding of the County Board and would like the Department to review.
Final Letter to Provider from Department/County Board noting POC has been accepted (PC050)
This letter is sent when the Department or County Board accepts the POC initially submitted by the participating provider.
Cover Letter for insufficient POC from Provider- Amended by Department/County Board and returned to Provider to readdress (PC051)
This letter is sent to the Provider noting that the Department or County Board did not concur with the “provider submitted POC”. A modified POC has been completed by the Department or County Board for the provider to use for a second response of compliance. The modified POC is enclosed with this letter.
Final POC Acceptance letter to provider on amended POC (PC052)
This acceptance letter is sent to the Provider stating satisfactory compliance to the POC that had been amended by the Department or County Board and sent back to the Provider to re-address.
Cover letter to provider -NO POC Submitted as required Department/County Board Created POC –Sent to Provider (PC053)
This cover letter states that, due to a lack of response by the provider to submit the required POC, the Department or County Board has completed the POC for the provider. The provider is now required to satisfactorily address and comply with the provisions in the “imposed” POC.
Final Acceptance Letter To Provider for POC that was developed by Department/County Board (PC054)
This letter states that the provider has satisfactorily complied with the “imposed POC” that was developed by the Department/County Board due to non-response of the provider after findings were identified during the compliance review.
Instructions on “How to Complete the POC - For County Board Provider Reviews” (PC057)
These instructions will be used as a guideline by providers for developing and submitting POCs in response to PC reviews conducted by the County Board.