Get Pae Certification Form

Filling out the Pae Certification Form online is a crucial step in ensuring eligibility for long-term care services. This guide will walk you through each section of the form to facilitate a smooth completion process.

Follow the steps to efficiently complete the Pae Certification Form.

1. Click ‘Get Form’ button to access the Pae Certification Form and open it in your preferred editing tool.
2. Begin by entering the applicant’s name and Social Security Number (SSN) at the top of the form. Ensure that this information is accurate, as it is vital for identifying the applicant.
3. In the 'PAE Request Date' section, enter the date when the certification request is being submitted. This date should reflect the current timeline for processing the application.
4. Make sure to attach the required documents listed in the section for required attachments. These documents may include a recent history and physical or other medical records supporting the applicant’s needs, and current physician's orders for nursing facility services.
5. Fill out the Certification of Assessment section. The certifier, which can be a physician or other qualified healthcare provider, needs to sign and date this section, indicating the accuracy of the provided information.
6. In the Physician Certification of Level of Care section, the physician (or other qualifying individual) must confirm the necessity of nursing facility services for the applicant, signing and entering their credentials.
7. If applicable, complete the Certification Update section. This is necessary only if the PAE must be recertified, ensuring that the applicant’s condition is consistent with the prior submission.
8. Finally, review all entered information for accuracy. Once verified, you can save changes, download the completed form, print it for physical copies, or share it as needed.

Take action today by completing the Pae Certification Form online to ensure timely processing of your application.