Fully Executed Interlocal - Laserfiche WebLink

Home Browse Search

Docusign Envelope lD: C l 90C649-709E-4E0GA409-4Al 6CED8C800 4.8 4.7 .5.1.2. All daily logs must have a quarterly summary rolling up all time over the quarter' 4.7.5.2'ThesestaffmustcompleteaSinglecostobjective certification quarterly using an HCA approved form' 4.7.5.g. Each single cost objective staff must be reported individually on the invoice. 4.7.5.4. The invoice must report the name, the actual amount of time spent performing allowable MAC activities, and totaldollar amount claimed for reimbursement for each staff' Direct Charge for lnterpretation Service Contracts The Contractor may only direct charge for a portion of the lnterpretation Service contracts and only for allowable interpretation activities as described in this Agreement. 4.g.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 lnterpretation services contract in the calculation for FFP reimbursement. 4.g.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: 4.8.2.1. 4.8.2.2. 4.8.2.3. 4.8.2.4. 4.8.2.5. 4.8.2.6. 4.8.2.7. Appointment time/duration; Client Name/l D/transaction information; lnterpreter AgencY; lnterpreter Name or EmPloYee lD; Language/communication tYPe; Requestor or nurse name; and The forms must be maintained according to SOS Record's retention schedule. 4.8.3. Washington State Health Care Authority The above data from all patient encounter forms, except Client Name/lD lnformation, must be transferred onto a single spreadsheet that is searchable and sortable must be available upon request' When requested, the data will be provided in a readable, usable, mutually agreed upon format. HCA Contract #K8630 Attachment 5 25