Providers > Changes to WiSCC Procedure

Effective July 1 2007, Delmarva WiSCC Consultants will review a randomly selected third record from the WSC's case load.

Solo WSC

The WiSCC consultant (QIC) will continue to randomly select two individuals from the WSC's case load per procedure. In addition the QIC will select a third record randomly using the WiSCC application function. This will be the record used for the "unannounced" record review. The WSC will be given the name for the third record on the second day of the WiSCC or when record reviews begin. If the WiSCC is not conducted in the WSC's office, on the 1^st day of the WiSCC the QIC will inform the WSC that the following morning, they will be getting a phone call from the QIC informing them of the name for the additional record. Determinations for Elements #1 through #6; Elements #7, #8, and #10 will be made prior to review of the third record.

The third record is a review for Elements #9 and #11 only. The QIC should review the prior 6 months of information to verify compliance with Elements #9 and #11. If the requirements for face to face visits are less frequent for the individual represented in the third record the QIC may review an additional six months of the record.

The review of the third record should be completed in fifteen minutes. This review is not intended to be an in depth review of all documents in the record. It is meant to confirm/verify the following documents are present:

Element #9
1. The pen and ink cost plan signed by the person or legal guardian.
2. The current cost plan.
3. The service authorizations for the period in review.

Element #11
1. The current Support Plan signed by the person or legal guardian.
2. The progress notes reflect the required face to face contacts.
3. The progress notes reflect the required secondary contacts.

In reviewing the third record when any item under Element #9 and Element #11 is determined to be Not Met, the third record review is complete. The QIC will not continue to review the record but should proceed to inform the WSC of the missing documentation.

If the findings in the third record indicate either Element #9 or Element #11 are "Not Met", this will be documented at the WSC Level of the WiSCC application for those particular elements. The findings will also indicate the Element was "Not Met" due to findings in the third record. The QIC will also identify the individual's first name and last initial and the specific dates and/or date ranges affected by the missing documentation or information.

Agency WSC

The same procedure will also be used for Agency WSCs. A third record should be randomly selected for each WSC selected as part of an agency WiSCC.