Provider Compliance Reviews

Provider Compliance Reviews are completed according to OAC 5123:2-2-04. All certified providers are required to have a routine compliance review conducted within one year of the certified provider's initial billing for provision of services. Thereafter, routine compliance reviews shall be conducted so that each certified provider is reviewed once during the term of certification.

The Southern Ohio Council completes compliance reviews, as determined by DODD. The Provider Compliance Reviewer completes routine, special and abbreviated compliance reviews. A special review can be conducted as necessary due to health, safety or welfare of an individual; a complaint or allegation or based on a MUI that may indicate the certified provider's failure to comply with applicable requirements. An abbreviated review can only be conducted with DODD approval.

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