Youth Empowerment Services (YES) Waiver

Credentialing Criteria

Credentialing Timeline

The DSHS credentialing process will consist of both a desk review and on-site review. DSHS may contact the applicant at any time during the process to request additional information to assist with the review of the application. Pending receipt of all requested information, the desk review should be complete within 7-10 business days. DSHS will notify the applicant via email when this process is complete and to schedule the on-site review. It is anticipated that the on-site review will occur within four weeks of the completed desk review on a mutually agreed upon date.

Additional Information

The Desk Review will include, but is not limited to, the review and verification of:

· review of organization Medicaid provider number (if applicable)

· review of National Provider Identifier (NPI) Number (if applicable)

· compliance with NOE submittal instructions

· submission of all applicable documentation outlined on the NOE application checklist

· verification that organization and staff are not reported on the OIG website

The Site Review will include, but is not limited to, the review and verification of:

· licensing and accreditation status

· responsible entities regarding provision of all Waiver services, including review of subcontractor agreements (if applicable)

· facility, staff, and appointment availability

· organization policies and procedures for credentialing, training, education, licensure, certification and registration documentation

· Criminal History / Background Checks for all staff involved in the administration and provision of Waiver services

· personnel files related to credentialing and background

· Quality Assurance and Quality Management policies and procedures

· clinical operations and related policies and procedures

· treatment records and related policies and procedures

· safety policies and procedures and operations

· organizational/facility appearance or environment

· client records

· confidentiality policies and procedures and practices

· Utilization Review and Utilization Management policies and procedures and practices

· organizational structure and staffing

· medication safety policies and procedures and practices

· provider staff qualifications to conduct services as described in Waiver

· required qualifications per professional standards and regulations, including malpractice or liability insurance for professional staff

6/26/2009