Certification Survey and Audit Report

 
 100% of survey complete.
The use of this survey is voluntary and for informational purposes only. Unless specifically noted the data will be reported in the aggregate and all names provided will be kept confidential. For further information please contact lhartmann@herkimerarc.org.

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* 1. Start date of visit

Date

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* 2. Organization who completed the review

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* 3. Type of review

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* 4. Services reviewed

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* 5. How many auditors were present

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* 6. How many days were the auditors present

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* 7. The auditors reviewed (Please check all that apply)

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* 8. Sample size:

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* 9. Sample size for number of claims reviewed:

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* 10. Audit period reviewed?

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* 11. Describe the ISP used during the visit?

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* 12. Did the survey team discuss the concept of meaningful outcomes?

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* 13. Were there any deficiencies/ findings?

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* 14. Were there any recommendations

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* 15. Was there any difficulties that you would like to share?

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* 16. Were the sessions at the June Statewide Meeting or Fall Symposium helpful to you in preparing for external audits or reviews?

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* 17. How can the Association assist the Providers to better prepare for surveys and audits?

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* 18. Would you like additional assistance or to make additional comments?

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