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(a) Daily logs must be maintained according to the SOS record's retention schedule. (b) All daily logs must have a quarterly summary rolling up all time over the quarter. (2) These staff must complete a single cost objective certification quarterly using an HCA approved form. (3) Each single cost objective staff must be reported individually on the invoice. (4) The invoice must report the name, the actual amount of time spent performing allowable MAC activities, and total dollar amount claimed for reimbursement for each staff. d) Direct Charge for Interpretation Service Contracts The Contractor may only direct charge for a portion of Interpretation Service contracts for allowable interpretation activities as described in this Agreement. (1) Services direct charged must be for interpretation activities identified as allowable activities within the Manual, the CAP, and this Agreement. The Contractor is prohibited from including any other portion of an Interpretation Services Contract in the calculation for FFP reimbursement. (2) Each interpretation activity must be documented to HCA's satisfaction, in fifteen (15) minute increments, using a patient encounter form that includes, at minimum, the following data elements:. (a) Appointment time/duration (b) Client Name/ID/transaction information (c) Interpreter Agency (d) Interpreter Name or Employee ID (e) Language/communication type (f) Requestor or nurse name (g) The forms must be maintained according to SOS Record's retention schedule. (3) The above data from all patient encounter forms, except Client Name/ID Information, must be transferred onto a single spreadsheet that is searchable and sortable. This may be accomplished by direct data entry into the System so long as the data is extractable into a searchable and sortable spreadsheet. (4) The invoice must report a summary for each Interpretation Service contract including the names of the interpreting staff, the total amount of time spent performing allowable MAC activities, and total dollar amount claimed for reimbursement. (5) The contractor is prohibited from altering the information on the patient encounter forms and certifies the accuracy of the data entered into the spreadsheet and the System by signing the A19 by an authorized Contractor representative. Local Health Jurisdiction Page 53 of 59 Medicaid Administrative Claiming Washington State Health Care Authority Contract # K3069