1. What to Expect When Your System is Selected

2. * Notification * Preparation * The Review * Preliminary Findings * Final Report * Follow Up

3. * Date of review * List of children * List of documents that must be available * Information about family interviews * Notice sent * One week in advance for site visits * Two weeks in advance for desk audits

4. * Local Site Visits * Desk Audits

5. * Review Elements * Self-Assessment Tool * Communication with Local System Manager * Missing Information * Questions and Clarifications * Exit Interview

6. * Written Report * Within 30 days of review * Includes * Purpose of review * Overview of strengths, required TA, need for IP * List of retractions * Opportunity to provide additional documentation * Opportunity to make billing adjustments

7. * Sent via Certified Mail * 30 days after preliminary report, or * 30 days after receipt of additional information * Includes * Strengths, Required TA, Required IP * Family Interview Summary * Final Retraction List * Info that will be sent to DMAS Fiscal Unit * Appeal Process information (30 day timeline)

8. * DMAS * DMAS Fiscal Unit – Follow Up on Retractions * Local System * Communicate Findings to LLA staff and contracted providers * Develop/Implement Improvement Plan * ITCVA Monitoring and TA staff work with LSM * Required TA * Oversight of Improvement Plan

9. * For the Review itself * Site Visits * Desk Audits * For Positive Findings * Ongoing mechanisms for assuring qualified providers, adherence to requirements, quality services, effective processes, including documentation * Sample Tool * For Follow up

10. * Family satisfaction; perception that services have made a difference in child’s development * Requirements usually met * Some great examples of coaching, communication and collaboration, and documentation

11. * Documentation requirements * EI Processes and procedures * ASP, IFSPs, IFSP reviews * Determining outcomes/goals * Determining services – team process * Service delivery * Assuring qualified providers * Accurate billing

12. * Missing/late Physician Certification * Practitioner not qualified * Incorrect codes * Billing more time than documented and/or than specified by IFSP * Billing date doesn’t match date of service * No evidence that parent was present