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Discovery Review Tools ~ July 1, 2014 – December 30, 2014

Return to FSQAP Discovery Review Tools Archive

Review Tools ~ (PDF)

Person Centered Review (PCR)

TitleRecord Review Tool
Individual Interview Instrument (February 2010)Download
Health SummaryDownload

Provider Discovery Review (PDR)

TitleRecord Review Tool
Observation Review ChecklistDownload

Service Specific Individual Record Review (SSRR)

TitleRecord Review Tool
Behavior AnalysisDownload
Behavior AssistantDownload
CDC+ ConsultantDownload
CDC+ RepresentativeDownload
Life Skills Development 1 (Companion)Download
Life Skills Development 2 (Supported Employment)Download
Life Skills Development 3 (Adult Day Training)Download
Personal SupportsDownload
Residential Habilitation (Standard)Download
Residential Habilitation (Behavior Focus)Download
Residential Habilitation (Intensive Behavior)Download
Respite (under 21)Download
Special Medical Home CareDownload
Supported Living CoachingDownload
Waiver Support CoordinationDownload

Request for Reconsideration (updated February 1, 2014)
If you disagree with the findings related to noted billing discrepancies in your Provider Discovery Review (PDR) report, you may request a Reconsideration Review.  The Reconsideration Request must be made in writing (using the Reconsideration Request form located below) and received within 30 days of your receipt of the annual PDR report.