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SD/MC PROVIDER CERTIFICATION & RE-CERTIFICATION PROTOCOL Department of Health Care Services (DOCS) *Revised June 2014* COUNTY: DATE: PROVIDER NUMBER: NPI #: DAYS/HOURS OF OPERATION: PROVIDER NAME:
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How to fill out provider site re-certification protocol

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How to fill out provider site re-certification protocol:

01
Review the instructions: Before starting the process, carefully read the guidelines and instructions provided for filling out the provider site re-certification protocol. Make sure you understand the requirements and procedures involved.
02
Gather required information: Collect all the necessary information and documentation needed to complete the protocol. This may include details about the provider site, such as its address, contact information, and relevant certifications or licenses.
03
Complete the sections: Start by filling out the basic information section, which typically includes the name of the provider, date of submission, and any unique identification numbers. Then, proceed to fill out the specific sections as outlined in the protocol. These sections may cover various aspects, such as compliance with regulations, quality control measures, and staff qualifications.
04
Provide accurate information: Ensure that all the information provided is accurate and up to date. Double-check the data before submitting it to avoid any discrepancies or errors that could delay the re-certification process.
05
Include supporting documents: Attach any necessary supporting documents required by the protocol. These may include certifications, licenses, training records, or inspection reports. Make sure these documents are properly labeled and organized for easy reference.
06
Review and proofread: Once you have completed filling out the protocol, take the time to review and proofread your answers. Check for any spelling or grammatical errors and verify that all the required sections have been adequately addressed.
07
Submit the protocol: Follow the specified submission procedures to submit the filled-out provider site re-certification protocol. This may involve mailing a hard copy or submitting it electronically through an online portal or email.

Who needs provider site re-certification protocol:

01
Healthcare providers: Medical facilities, hospitals, clinics, or any healthcare establishment that offers services to patients may require a provider site re-certification protocol. This ensures that they meet the necessary standards and can continue providing quality care.
02
Educational institutions: Schools, universities, or training centers that offer programs in healthcare or related fields may need a provider site re-certification to ensure compliance with educational requirements and regulations.
03
Government agencies: Providers of government-funded healthcare services or services that require government approval or oversight may be required to undergo re-certification protocols to maintain their eligibility and status.
Note: The specific requirements for provider site re-certification protocols may vary depending on the industry, location, and governing bodies involved. It's important to consult the relevant guidelines and regulations applicable to your specific situation.
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Provider site re-certification protocol is a process to ensure that provider sites are meeting all necessary requirements and standards to continue providing services.
All providers who operate service sites are required to file provider site re-certification protocols.
Provider site re-certification protocols can be filled out online through the designated portal or submitted via mail.
The purpose of provider site re-certification protocol is to ensure that provider sites are maintaining compliance with regulations and providing quality services.
Provider site re-certification protocols require reporting of site locations, services provided, staff qualifications, and any updates or changes since the last filing.
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