Parent Verification Form Report

This report was built to comply with the requirements of the regional centers in the state of California. This report will pull the required DS 5862 Parent Verification form that captures parent signatures based on staff collecting the electronic signatures from parents via Rethink’s scheduler.

Action

Description

Good to Know

Action

Description

Good to Know

Step 1: Click on Reporting Dashboard>Parent Verification Form

  • Users with permission “View/Download Parent Verification” will be able to view/download this report

  • If you have the appropriate permissions and do not see this report, reach out to support@rethinkbh.com to get it added to your account

Step 2: Select Funder(s), Client(s), Locations(s) Appointment Type(s), and Report Month

 

  • Must select at least one funder

  • If Clients are left blank, report will pull all clients with the selected funder

  • If Location is left blank, report will pull all clients in all locations with the selected funder

  • Appointment Type options include Billable, Nonbillable, and Travel

    • Will default to Billable type appointments

  • Must select one Report Month before generating the report

Step 3: Appointment Requirements

 

  • The Appointment Requirements will be auto selected based on what you have chosen under the company account>scheduling section to require for billable sessions to be considered complete

    • You can remove or add requirements as needed

  • Only pull over appointments that have Parent Verification

Step 4: Select Download PDF File or Save to File Cabinet

The PDF will generate separate pages per client showing the following information:

  • Required labeling for regional centers, client name, UCI # if entered in client demographics page, vendor name (company name), vendor # (from Funder setup), phone number on company account page, month/year selected for report

  • The chart will show the date of service, location of service selected on the appointment level, name and credential of staff providing services, description of service (service name), service/billing code, start/end times of appointments, parent verification as obtained on appointments

  • The back of the form will include language required for regional centers, parent name, signature, and the date. This is captured based on the last parent verification

See Sample PVF:

 

  • If “Save to File Cabinet” is selected, the appropriate PDF will save to the client’s filing cabinet under the Folder “DDS-Parent Verification Form Folder” showing the month you ran it for and the date the report was pulled

  • Can print form/send to regional centers