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Get Case Activity Report 2020-2025
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How to fill out the Case Activity Report online
Filling out the Case Activity Report is essential for documenting the Medicaid status of applicants and members at your facility. This guide provides clear, step-by-step instructions to help you complete the form efficiently and accurately.
Follow the steps to complete your Case Activity Report online.
- Press the ‘Get Form’ button to access the Case Activity Report and open it in your editing software.
- Begin with section 1, 'Member Data.' Enter the member's name, date they entered the facility, Social Security number, State ID, and case number.
- Move to section 2, 'Facility Data.' Fill in the provider number or NPI number, specify the facility type, and provide the name of the facility along with the DHS per diem, street address, city, state, ZIP code, date completed, and the signature of the person completing the form.
- Next, complete the 'Level of Care' section for swingbed, hospice, MHI, and other classifications, if applicable. Indicate if this is related to PMIC mental health or substance abuse if relevant.
- Proceed to section 4, 'Medicare Information,' if there are any relevant changes in coverage. Indicate whether you expect the stay to be covered by Medicare and provide expected dates of coverage if applicable.
- Finally, fill out the discharge data in section 5: date of discharge, reason for discharge, and other necessary details about the resident's last month in the facility.
- Once you have filled in all required sections, ensure all information is accurate, then save your changes. You may download, print, or share the document as needed.
Complete your Case Activity Report online today to ensure timely and accurate reporting.
When writing a work activity report, start by naming the report and specifying the reporting period. Detail each activity performed, categorizing them by project or task, and include outcomes or metrics where possible. Conclude with a summary of accomplishments and future action items, utilizing your Case Activity Report to enhance your work's transparency and effectiveness.
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