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Lane County CDDP
Exemption Request for EVE Entries
Name:ProviderNumber:
(REQUIRED)(REQUIRED)ReasonforExceptionEVV
PleaseselectALLthatapply:
I, andtheindividual(s)Support, donothaveaphoneortabletthatcanaccessEVV
IhaveaccesstoaphoneortabletthatcanaccessEVVbutthereisnointernetconnectionavailableinthe
homesoftheindividual(s)Support
IhaveaccesstoaphoneortabletthatcanaccessEVVbutthereisnomobiledatac
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What is evv exception form v4xlsx?
The EVV Exception Form v4.xlsx is a document used to report exceptions related to electronic visit verification (EVV) processes, enabling providers to explain any discrepancies in service delivery records.
Who is required to file evv exception form v4xlsx?
Providers who deliver services that are subject to electronic visit verification requirements are required to file the EVV Exception Form v4.xlsx when there are exceptions to the standard reporting.
How to fill out evv exception form v4xlsx?
To fill out the EVV Exception Form v4.xlsx, users should enter pertinent information such as the client's details, service dates, exception reasons, and any additional comments necessary to clarify the discrepancies.
What is the purpose of evv exception form v4xlsx?
The purpose of the EVV Exception Form v4.xlsx is to provide a means for service providers to document and explain exceptions to the electronic visit verification process, ensuring compliance and accountability.
What information must be reported on evv exception form v4xlsx?
Information that must be reported includes client identification, dates of service, reasons for the exception, service type, and provider details.
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