Get Corrective Action Form Template Excel

This guide provides a detailed and user-friendly approach to filling out the Corrective Action Form Template Excel online. By following the structured steps outlined below, users can ensure they complete the form accurately and efficiently.

Follow the steps to complete the Corrective Action Form Template online.

1. Click the 'Get Form' button to access the Corrective Action Form Template Excel. This will allow you to open the form and begin filling it out in the editor.
2. In Line A, enter the name of the State submitting the report along with the Federal fiscal year that corresponds to the corrective action plan.
3. Proceed to Line B to fill in the date of submission to CMS. Ensure that the format is clear and consistent, such as 'October 31, 2023'.
4. Complete Line C with the name, phone number, and email address of the assigned State contact person for the plan.
5. For Line D, enter the Medicaid payment error rate. This includes entering specific rates for fee-for-service, managed care, and eligibility rates in the respective lines.
6. Line E requires you to enter the Children’s Health Insurance Program (CHIP) payment error rate. Follow the same procedure as in Line D for entering the respective rates.
7. In Line F, provide a summary of the causes of errors for both Medicaid and CHIP programs. Make sure to include a description of the planned corrective actions to address these errors.
8. After completing all required fields, review your entries for accuracy. Finally, you can save changes, download the form, print it, or share it as needed.

Start filling out the Corrective Action Form Template online today to ensure accurate reporting and effective corrective action planning.