SAMPLE POLICY WORK

Policy on Collaboration with TennCare

Policy Statement: Simpl Care Services LLC must collaborate closely with TennCare or its designated representative to secure pre-admission evaluation approval. All PAEs and subsequent documentation must be submitted to the appropriate TennCare contacts and include any required supporting materials.

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Communication Protocol: Following the evaluation, assessment teams are required to compile a digital case summary and supporting evidence. This package is then transmitted via a secure, regulated communication channel to TennCare for review. Follow-Up and Clarification: A designated liaison from the Compliance and Regulatory Affairs team coordinates with TennCare to address questions, provide additional documentation, or modify care recommendations based on regulatory feedback.

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Policy on Documentation and Record Maintenance

Policy Statement: Complete and accurate documentation of PAEs is mandatory. Assessment results, communications with TennCare, and any supplementary clinical reports must be recorded in the centralized electronic records system maintained by Simpl Care Services LLC.

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Storage and Access: All PAE results are to be scanned, securely stored, and retained in accordance with HIPAA, TennCare, and state licensing standards. Digital records must be accessible to authorized personnel for review, audit, or compliance monitoring purposes. Version Control and Security: The electronic record system will maintain a revision history that logs any updates or modifications to the PAE documents. Access to this repository is restricted to the assessment, compliance, and quality assurance teams.

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c. Scope and Applicability This Level of Care Assessment policy applies to all staff involved in the pre-admission, clinical, and administrative processes at Simpl Care Services LLC. It includes, but is not limited to: • Clinical staff such as psychologists, nurses, physicians, and developmental specialists. • Care coordinators and eligibility specialists responsible for the collection, review, and verification of assessment documentation.