Documentation. Requirements for documentation can be found in service specific rules available on the dodd.ohio.gov website under Rules in Effect.



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OAC 5:-9-06 (H) Service documentation Documentation () Providers shall maintain service documentation in accordance with this rule and servicespecific rules in Chapter 5:-9 of the Administrative Code. () Invoices a provider submits to the department for payment for services delivered shall not be considered service documentation. Any information contained in the submitted invoice may not and shall not be substituted for any required service documentation information that a provider is required to maintain to validate payment for Medicaid services. () Each provider shall maintain all service documentation in an accessible location. The service documentation shall be available, upon request, for review by the centers for Medicare and Medicaid services, the Ohio department of Medicaid, the department, a county board or regional council of governments that submits to the department payment authorization for the service, and those designated or assigned authority by the Ohio department of Medicaid or the department to review service documentation. (4) If a provider discontinues operations, the provider shall, within seven days of discontinuance, notify the county boards for the counties in which individuals to whom the provider has provided services reside, of the location where the service documentation will be stored, and provide the county board with the name and telephone number of the person responsible for maintaining the service documentation. Requirements for documentation can be found in service specific rules available on the dodd.ohio.gov website under Rules in Effect.

OAC 5:-9-4 (E) Documentation of services HPC transportation () Service documentation for transportation shall include each of the following to validate payment for Medicaid services: a. Type of service. b. (b) Date of service. (c) Name of individual receiving service. c. (d) Medicaid identification number of individual receiving service. d. (e) Name of provider. e. (f) Provider identifier/contract number. f. (g) Origination and destination points of transportation provided. g. (h) Total number of miles of transportation provided. h. Group size in which transportation is provided. i. (j) Written or electronic signature of the person delivering the service, or initials of the person delivering the service if a signature and corresponding initials are on file with the provider. j. (k) Description and details of the services delivered that directly relate to the services specified in the approved individual service plan as the services to be provided.

HPC Transportation() Log/Documentation Sheet Provider Name (5): Contract #(6): Driver Signature (0) Date Origin (7) Destination (7) Miles (8) Group Size (9) ISP Related Reason (0) Individual Initials ()

Sample Situation Rory Drury is an independent provider who is certified to provide Homemaker/Personal Care-Transportation (ATN & FTN) and is authorized to drive two individuals, Steven and Joe, who live together in an apartment. Rory drives them to and from outings in the community and to appointments as authorized in their respective service plans. Rory is also authorized to drive Steven s friend, Chloe, to outings together occasionally when they request to go out together. Steven & Joe each have 00 miles per month authorized in their service plan. Each week, Joe and Steven sit down and make up a calendar of activities and appointments they want to schedule during the week so that they can arrange for transportation with Rory. Rory confirms the schedule and commits that he is able to follow the schedule. The next page is an example of how Rory might document his services.

HPC Transportation() Log/Documentation Sheet Provider Name (5): Contract #(6): Driver Signature (0) Rory Drury 456 Rory Drury Joe Fiditch 9876540 IO Steven Doe 876540 IO Chloe Smith 765400 LV Individual Initials () Date Origin (7) Destination (7) Miles (8) Group Size (9) JF SD CS //4 7 75 Community Outing //4 75 78 Community Outing //4 78 Main St. Theater 86 8 Community Outing-movie //4 Main St. Theater 86 94 8 ISP Related Reason (0) Community Outing-movie /7/4 94 The Dental Center 96 X Med Appointment /7/4 The Dental Center 96 98 Med Appointment X /9/4 98 40 Grocery Shopping /9/4 40 404 Grocery Shopping //4 404 The Pizza Pan 405 X Community Outing & Dinner //4 The Pizza Pan 405 406 Community Outing & Dinner X