Get Oaas Tsepa Form

The Oaas Tsepa Form is essential for the pre-approval and final approval of transition service requests. This guide aims to assist users in effectively completing the form online, ensuring a smooth submission process.

Follow the steps to complete the Oaas Tsepa Form online.

1. Press the ‘Get Form’ button to access the Oaas Tsepa Form. This action will open the form in an online editor.
2. Begin filling out the Waiver Type section by selecting the appropriate option, such as OAAS Regional Office or others.
3. Enter the Waiver Applicant's Name and SSN in the designated fields to identify the applicant.
4. Input the Projected Move Date for planning purposes.
5. Fill in the Pre-142 Approval Date and Final Approved TSEPA Date fields as applicable.
6. Document the Actual Move Date along with the Nursing Facility Name in the respective sections.
7. In the Total Actual Cost and Total Estimated Cost sections, provide the respective figures that apply to your situation.
8. Move to the Itemized TSEPA Expenses section and fill in the details for each item: Area, Item, Designated Purchaser's Initials, Number of Items Requested, and Estimated Cost.
9. Review the Health, Safety, and Welfare Assurances section to ensure all necessary items for safety are included.
10. Complete the Pre-Approval Authorization section with the amount and the signatures where required.
11. Provide the Support Coordination Agency Information, including the contact details of the agency and signature.
12. Fill out the Designated Purchaser Information for each designated purchaser with their respective agency details and signatures.
13. Ensure the section for OAAS Regional Office final approval is prepared for review, filling in necessary details.
14. After completing all sections, save your changes, download a copy for your records, or print the form directly.

Complete your Oaas Tsepa Form online today for smooth transition service approval.