These are the DDD required documents. The rules for each are listed. If you have missing documents you should check on settings, assignments, authorization and/or billings.

 

Document Name: 18+ Verified (Passport, Birth Certificate)

• Required when: A provider has a license to provider Speech, Occupational or Physical Therapy
• Required when: The individual has a role as a provider

Document Name: A4

• Required when: A provider is a W2 employee

Document Name: Abuse and Neglect Training

• Required when: A provider is assigned to a DTA/Center
• Required when: A provider is assigned to a group home or IDLA

Document Name: Agreement to Search DCW database

• Required when: A provider is assigned to a member that has S5125 authorizations and the provider has a payroll rate for S5125

Document Name: AHCCCS Contingency Plan

• Required when: An individual that is responsible as the person for signatures on documents
• Required when: A guardian that is the responsible person when more than one guardian is assigned.
• Required when: A guardian assigned to a member for which they responsible for that has any billing codes required for EVV
• Required when: A member that has authorization for any billing code that requires EVV

Document Name: Arizona Adult Protective Services

• Required when: The individual has a role as a provider

Document Name: Article 9 (prohibitions)

• Required when: A provider has a license to provider Speech, Occupational or Physical Therapy
• Required when: The individual has a role as a provider

Document Name: ATC Responsibility Agreement

• Required when: A provider has provided S5125 in the past based on billing records
• Required when: A provider that has S5125 payroll rates assigned
• Required when: A Guardian has signatory rights for a member that has S5125 authorizations
• Required when: A member has S5125 valid current authorizations

Document Name: Central Registry

• Required when: A provider has a license to provider Speech, Occupational or Physical Therapy
• Required when: The individual has a role as a provider

Document Name: CPR Certification

• Required when: A provider has a license to provider Speech, Occupational or Physical Therapy
• Required when: The individual has a role as a provider

Document Name: Criminal History Affidavit

• Required when: A provider has a license to provider Speech, Occupational or Physical Therapy
• Required when: The individual has a role as a provider

Document Name: Current Prevention and Support

• Required when: A provider is assigned to a member that needs positive behavior support

Document Name: DCW Developmental Disabilities (Level 2)

• Required when: A provider provides S5125
• Required when: A member assigned to the provider has S5125 Authorizations
• Required when: A provider is not a family member
• Required when: Provider is an uncle or cousin

Document Name: DCW Fundamentals (level 1)

• Required when: A provider is assigned to a member that has S5125 authorizations and the provider has a payroll rate for S5125

Document Name: DCW Transcript

• Required when: A provider is assigned to a member that has S5125 authorizations and the provider has a payroll rate for S5125

Document Name: Direct Service Position Certification

• Required when: A provider has a license to provider Speech, Occupational or Physical Therapy
• Required when: The individual has a role as a provider

Document Name: Drivers License

• Required when: A provider is an approved driver

Document Name: EVV Designee Attestation

• Required when: An individual is assigned as a signator to a member that does not have Guardianship
• Required when: A provider that lives with the member that has no one else to sign for their services and allowed to sign their own timecard

Document Name: EVV Paper TimeSheet Attestation

• Required when: A provider is using a FOB or has some excusable reason for not using EVV

Document Name: Fingerprint Application

• Required when: A person has a role as a provider
• Required when: A parent provider that performs more than S5125 service

Document Name: Fingerprint Card Verified

• Required when: A person has a role as a provider
• Required when: A parent provider that performs more than S5125 service

Document Name: Fingerprint Clearance Card

• Required when: A person has a role as a provider
• Required when: A parent provider that performs more than S5125 service

Document Name: First Aid Certification

• Required when: The individual has a role as a provider

Document Name: I9

• Required when: A provider is a W2 employee

Document Name: Initial OIG Hire Check

• Required when: A provider has a license to provider Speech, Occupational or Physical Therapy
• Required when: The individual has a role as a provider

Document Name: Initial SAMS Hire Check

• Required when: A provider has a license to provider Speech, Occupational or Physical Therapy
• Required when: The individual has a role as a provider

Document Name: Liability Insurance

• Required when: A provider is an approved driver

Document Name: Motor Vehicle Record (MVR)

• Required when: A provider is an approved driver

Document Name: PCSP

• Required when: The individual has a role as a member

Document Name: PCSP Competency Check

• Required when: The individual has a role as a provider

Document Name: Pre-Service Provider Orientation

• Required when: A provider works with and is assigned to the member
• Required when: A therapist works with and is assigned to the member

Document Name: Professional License

• Required when: A provider has a license to provider Speech, Occupational or Physical Therapy

Document Name: Therapy Evaluation

• Required when: A member has authorizations assigned that are billed as therapy services
• Required when: A provider has a license to provider Speech, Occupational or Physical Therapy

Document Name: Therapy Plan of Care

• Required when: A member has authorizations assigned that are billed as therapy services
• Required when: A provider has a license to provider Speech, Occupational or Physical Therapy

Document Name: Three References

• Required when: A provider has a license to provider Speech, Occupational or Physical Therapy
• Required when: The individual has a role as a provider

Document Name: Vehicle inspection

• Required when: A provider is an approved driver

Document Name: Vehicle Registration

• Required when: A provider is an approved driver