Forms to Track / Home Health Certification and Plan of Care
assigned the form for review
Exported to HAS
LIMIT to 200 Records max. Please delete as needed.
RFA:
Form Date Patient Episode OASIS Status Match Frequency Primary Physician (HHRG) Primary Physician (CPC) Upload
07/02/2025 DUMMY, ADVANTAGE
MRN:
07/02/25 - 08/30/25
SOC (Billable)
SOC (Deleted)
Missing PCP - please coordinate with (Arnold)
12/20/2025 WALKER, BLANCHE
MRN: 900010253
12/20/25 - 12/19/26
REC (Billable)
REC (Exported to State) TAM, STEPHEN
NPI: 1689738478
Daniel 03/09/26 02:08 PM
submitted the form
11/19/2025 ROLAND, HARRIET
MRN: 900009679
11/19/25 - 01/17/26
SOC (Billable)
KATENDE, BURTSON
NPI: 1336722214
Lala 12/10/25 11:04 AM
assigned the form for review
12/02/2025 SHIPMAN, LINDA
MRN: 900010600
12/02/25 - 01/30/26
REC (Billable)
REC (Exported to State) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
01/23/2026 FLEETWOOD, JANET
MRN: 900009966
01/23/26 - 01/22/27
REC (Billable)
REC (Exported to State) MARGALLO, ROY MARIE
NPI: 1538314950
Daniel 03/09/26 02:06 PM
submitted the form
02/16/2026 TRUJILLO, SANDY
MRN: 900010726
02/16/26 - 02/15/27
SOC (Billable)
SOC (Exported to State) TAM, STEPHEN
NPI: 1689738478
TAM, STEPHEN
NPI: 1689738478
JM 03/25/26 03:37 PM
exported the form into HAS
02/17/2026 DUMMY, PATIENT
MRN: 900000185
05/01/25 - 04/30/26
SOC (Billable)
SOC (Submitted) SOC (Pending) CAPOBIANCO, LEO
NPI: 1063483097
03/06/2026 ADKINS, KATHERINE
MRN: 900010946
03/06/26 - 05/04/26
SOC (Billable)
SOC (Exported to State) ATIF, MOHAMMAD
NPI: 1801457882
ATIF, MOHAMMAD
NPI: 1801457882
Lala 04/01/26 04:16 PM
exported the form into HAS
03/09/2026 HARRINGTON, MARY
MRN: 900010949
03/09/26 - 05/07/26
SOC (Billable)
SOC (Reviewed) TAFRESHI, MEHRDAD
NPI: 1437115292
TAFRESHI, MEHRDAD
NPI: 1437115292
03/10/2026 OLSON, DONALD
MRN: 900010950
03/10/26 - 05/08/26
SOC (Billable)
SOC (Under Review) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/11/2026 NASSIF, GARY
MRN: 900010951
03/11/26 - 05/09/26
SOC (Billable)
SOC (Submitted) MILMAN, ADAM
NPI: 1912021262
MILMAN, ADAM
NPI: 1912021262
03/11/2026 PARELMAN, MARTIN
MRN: 900009823
03/11/26 - 05/09/26
SOC (Billable)
SOC (Submitted) GUMINA, ANTONIO
NPI: 1245292440
GUMINA, ANTONIO
NPI: 1245292440
03/11/2026 HENRIKSEN, KAREN
MRN: 900010940
03/11/26 - 05/09/26
SOC (Billable)
SOC (Submitted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/11/2026 LEIJA, DAVID
MRN: 900010953
03/11/26 - 05/09/26
SOC (Billable)
SOC (Submitted) ANJUM, SEEMA
NPI: 1629065842
ANJUM, SEEMA
NPI: 1629065842
03/12/2026 HARRISON, CURTIS
MRN: 900010963
03/12/26 - 05/10/26
SOC (Billable)
SOC (Submitted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/12/2026 CHIANG, MICHAEL
MRN: 900010962
03/12/26 - 05/10/26
SOC (Billable)
SOC (Submitted) KALE, JULIE
NPI: 1518705342
KALE, JULIE
NPI: 1518705342
03/12/2026 SHAW, THOMAS
MRN: 900010755
03/12/26 - 03/16/26
SOC (Billable)
SOC (Submitted) CHURCH, REBECCA
NPI: 1952653123
CHURCH, REBECCA
NPI: 1952653123
03/13/2026 ALSUP, LEONETTE
MRN: 900010959
03/13/26 - 05/11/26
SOC (Billable)
SOC (Submitted) MEIER, KENNETH
NPI: 1770049264
MEIER, KENNETH
NPI: 1770049264
03/13/2026 MOEN, SONDRA
MRN: 900010897
03/13/26 - 05/11/26
SOC (Billable)
SOC (Submitted) WRIGHT, TIERRA
NPI: 1437915758
WRIGHT, TIERRA
NPI: 1437915758
03/13/2026 QUINN, LESLI
MRN: 900010954
03/13/26 - 05/11/26
SOC (Billable)
SOC (Submitted) LICATA, PETER
NPI: 1336225747
LICATA, PETER
NPI: 1336225747
03/13/2026 SABRY, HODA
MRN: 900006572
03/13/26 - 05/11/26
SOC (Billable)
SOC (Submitted) HOSSAIN, TANVIR
NPI: 1881613891
HOSSAIN, TANVIR
NPI: 1881613891
03/14/2026 REGO, RALPH
MRN: 900010956
03/14/26 - 05/12/26
SOC (Billable)
SOC (Submitted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/14/2026 CROSE, LYNNE
MRN: 15111
03/14/26 - 03/19/26
SOC (Billable)
SOC (Submitted) CROSS, ANGELIQUE
NPI: 1073714705
CROSS, ANGELIQUE
NPI: 1073714705
03/15/2026 HELLING, MARLENE
MRN: 900010969
03/15/26 - 03/24/26
SOC (Billable)
SOC (Submitted) BHATIA, SONU
NPI: 1245281120
BHATIA, SONU
NPI: 1245281120
03/15/2026 BEARD, KATHERINE
MRN: 900010943
03/15/26 - 03/31/26
SOC (Billable)
SOC (Submitted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
Lala 04/01/26 04:18 PM
exported the form into HAS
03/16/2026 PARKER, JUNE
MRN: 900010964
03/16/26 - 05/14/26
SOC (Billable)
SOC (Submitted) MAHAJAN, RENU
NPI: 1609809607
MAHAJAN, RENU
NPI: 1609809607
03/17/2026 ROBINSON, JACKIE
MRN: 12323
03/17/26 - 05/15/26
SOC (Billable)
SOC (Submitted) MOJTABAVI, REZA
NPI: 1225152598
MOJTABAVI, REZA
NPI: 1225152598
03/18/2026 ALARCON, CHRISTINE
MRN: 900010970
03/18/26 - 05/16/26
SOC (Billable)
SOC (Submitted) PAN, HARRY
NPI: 1346688538
PAN, HARRY
NPI: 1346688538
03/18/2026 RUIZ ORTEGA, FRANCISCO
MRN: 900010811
03/18/26 - 05/16/26
REC (Billable)
REC (Deleted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/19/2026 DE LA ROSA, MARTHA
MRN: 900010972
03/19/26 - 04/02/26
SOC (Billable)
SOC (Submitted) CHINTA, SUNEETHA
NPI: 1720038185
CHINTA, SUNEETHA
NPI: 1720038185
03/19/2026 PEREZ, MARIA
MRN: 900010967
03/19/26 - 05/17/26
SOC (Billable)
SOC (Submitted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/19/2026 KOPP, MARILYN
MRN: 900010712
03/19/26 - 05/17/26
SOC (Billable)
SOC (Submitted) CHEN, THOMAS
NPI: 1992875538
03/19/2026 MERO, FELIPPA
MRN: 900010973
03/19/26 - 05/17/26
SOC (Billable)
SOC (Submitted) PENA, ROEHL
NPI: 1770520306
PENA, ROEHL
NPI: 1770520306
03/20/2026 BUNTROCK, HARRIETT
MRN: 900010976
03/20/26 - 05/18/26
SOC (Billable)
SOC (Submitted) LEHRNER, STEPHANIE
NPI: 1275700494
LEHRNER, STEPHANIE
NPI: 1275700494
03/20/2026 HORNE, CLAUDIA
MRN: 900010977
03/20/26 - 05/18/26
SOC (Billable)
SOC (Submitted) HAUS, ANDREW
NPI: 1437503059
03/20/2026 DELAGARZA, MELINDA
MRN: 900010978
03/20/26 - 05/18/26
SOC (Billable)
SOC (Submitted) DUGGAL, SEJAL
NPI: 1972814093
DUGGAL, SEJAL
NPI: 1972814093
03/21/2026 JOHNSON, CHERYL
MRN: 900010971
03/21/26 - 05/19/26
SOC (Billable)
SOC (Submitted) ACHIN, ROWENA
NPI: 1366467888
ACHIN, ROWENA
NPI: 1366467888
03/21/2026 THURMAN JR, ALBERT
MRN: 900010046
03/21/26 - 05/19/26
SOC (Billable)
SOC (Submitted) ADERANGI, FAEGH
NPI: 1942644760
ADERANGI, FAEGH
NPI: 1942644760
03/21/2026 NOZAKI, KENNETH
MRN: 900010822
03/21/26 - 05/19/26
REC (Billable)
REC (Submitted) PHAM, MATT
NPI: 1003917055
03/23/2026 KLUEVER , JAN
MRN: 900010982
03/23/26 - 05/21/26
SOC (Billable)
SOC (Submitted) WHITE, ROBERT
NPI: 1740208834
WHITE, ROBERT
NPI: 1740208834
03/23/2026 RILLSTONE, MARIAN
MRN: 900008794
03/23/26 - 05/21/26
SOC (Billable)
SOC (Submitted) CURRY, NAKEISHA
NPI: 1235197641
CURRY, NAKEISHA
NPI: 1235197641
03/23/2026 CROSE, LYNNE
MRN: 15111
03/23/26 - 05/21/26
SOC (Billable)
SOC (Submitted) CROSS, ANGELIQUE
NPI: 1073714705
CROSS, ANGELIQUE
NPI: 1073714705
03/23/2026 FITZGERALD, PATRICIA
MRN: 900010985
03/23/26 - 05/21/26
SOC (Billable)
SOC (Submitted) PINGOL, ELLAINE
NPI: 1679576060
PINGOL, ELLAINE
NPI: 1679576060
03/23/2026 MCGUIRE MITCHELL, V
MRN: 900010980
03/23/26 - 05/21/26
SOC (Billable)
SOC (Submitted) HABBI, MARIA
NPI: 1770991713
HABBI, MARIA
NPI: 1770991713
03/23/2026 BIJOLD, GERALD
MRN: 900010571
03/23/26 - 05/21/26
REC (Billable)
ROC (Submitted) REC (Reviewed) KIDIAVAYI, STANLEY
NPI: 1902290968
03/24/2026 NEWMAN, JOAN
MRN: 900010986
03/24/26 - 05/22/26
SOC (Billable)
SOC (Pending) IROHA, CHUKWUEMEKA
NPI: 1619942554
IROHA, CHUKWUEMEKA
NPI: 1619942554
03/24/2026 SCOTT, MARGARET
MRN: 900010984
03/24/26 - 05/22/26
SOC (Billable)
SOC (Submitted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/25/2026 JOHN, BERNADETTE
MRN: 900010836
03/25/26 - 05/23/26
REC (Billable)
REC (Pending) KIDIAVAYI, STANLEY
NPI: 1902290968
03/25/2026 SMITH, MARY
MRN: 900008161
03/25/26 - 05/23/26
SOC (Billable)
SOC (Submitted) CHOI, YUK KI
NPI: 1679928535
CHOI, YUK KI
NPI: 1679928535
03/26/2026 BESHERSE SR, LARRY
MRN: 900010361
03/26/26 - 05/24/26
REC (Billable)
REC (Reviewed) KIM, DAVID
NPI: 1396705661
03/26/2026 SANDOVAL, PAULINE
MRN: 900010830
03/26/26 - 05/24/26
REC (Billable)
REC (Reviewed) JOU, JASMINE
NPI: 1063909877
03/26/2026 RIVERS, GEORGE
MRN: 900010833
03/26/26 - 05/24/26
REC (Billable)
REC (Reviewed) GUILLEN, EDELAINE
NPI: 1740065754
03/26/2026 MILANEY, JUDITH
MRN: 900010992
03/26/26 - 05/24/26
SOC (Billable)
SOC (Submitted) CHOI, CHRISTOPHER
NPI: 1730117656
CHOI, CHRISTOPHER
NPI: 1730117656
03/26/2026 GIANDOMENICO, ROBERT
MRN: 900010988
03/26/26 - 05/24/26
SOC (Billable)
SOC (Submitted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/26/2026 RILEY, MARY
MRN: 900010991
03/26/26 - 05/24/26
SOC (Billable)
SOC (Submitted) BEDUYA-PRINCER, MARIA TESSIE
NPI: 1649249608
BEDUYA-PRINCER, MARIA TESSIE
NPI: 1649249608
03/27/2026 FALCO, LENORE
MRN: 900010831
03/27/26 - 05/25/26
REC (Billable)
REC (Deleted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/27/2026 BANDT, INARA
MRN: 900010989
03/27/26 - 05/25/26
SOC (Billable)
SOC (Submitted) STOERMER, CHRISTIAN
NPI: 1558495705
03/27/2026 WHITLEY, ANN
MRN: 900008129
03/27/26 - 05/25/26
SOC (Billable)
SOC (Submitted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/28/2026 HAMILTON, MICHAEL
MRN: 900010993
03/28/26 - 05/26/26
SOC (Billable)
SOC (Pending) BUADAENG, NIPAPORN
NPI: 1366939019
BUADAENG, NIPAPORN
NPI: 1366939019
03/29/2026 PROWS, DONNA
MRN: 900006676
03/29/26 - 05/27/26
REC (Billable)
REC (Reviewed) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/29/2026 SHALMY, DONALD
MRN: 900011001
03/29/26 - 05/27/26
SOC (Billable)
SOC (Pending) HOWARD, SHAIN
NPI: 1891172441
HOWARD, SHAIN
NPI: 1891172441
03/30/2026 DECKER, ROBERT
MRN: 900010983
03/30/26 - 05/28/26
SOC (Billable)
SOC (Submitted) AMELI, SEAN
NPI: 1801899968
AMELI, SEAN
NPI: 1801899968
03/30/2026 NGUYEN, BANG
MRN: 900011002
03/30/26 - 03/31/26
SOC (Billable)
SOC (Pending) HEDGER, RONALD
NPI: 1447576632
HEDGER, RONALD
NPI: 1447576632
03/30/2026 WILLIAMS, STANLEY
MRN: 900010906
03/30/26 - 05/28/26
SOC (Billable)
SOC (Pending) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/30/2026 RICE TUCKER, BARBIE
MRN: 900010848
03/30/26 - 05/28/26
REC (Billable)
REC (Pending) SAENZ, COURTNEY
NPI: 1376162057
03/31/2026 PARASCANDO, ELIZABETH
MRN: 900010851
03/31/26 - 05/29/26
REC (Billable)
REC (Submitted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/31/2026 BROWN, ERMA
MRN: 900011006
03/31/26 - 05/29/26
SOC (Billable)
SOC (Submitted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/31/2026 SPRINGGATE, TRUDY
MRN: 900007630
03/31/26 - 05/29/26
SOC (Billable)
SOC (Submitted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
03/31/2026 NOCERINO, CATHERINE
MRN: 900001545
03/31/26 - 05/29/26
SOC (Billable)
SOC (Submitted) DEL ROSARIO, MEGAN
NPI: 1275119943
DEL ROSARIO, MEGAN
NPI: 1275119943
03/31/2026 MOHN, KATHLEEN
MRN: 900010749
03/31/26 - 05/29/26
SOC (Billable)
SOC (Submitted) WOLFSON, ERIC
NPI: 1023044773
04/01/2026 VILLAZANA LOPEZ, JUAN
MRN: 900011007
04/01/26 - 05/30/26
SOC (Billable)
SOC (Pending) MACHUCA, ROGELIO
NPI: 1245492966
04/01/2026 LARSON, MARILYN
MRN: 900010987
04/01/26 - 05/30/26
SOC (Billable)
SOC (Submitted) TANG, KOCHY
NPI: 1902826365
TANG, KOCHY
NPI: 1902826365
04/02/2026 GREGG, LINDA
MRN: 900011008
04/02/26 - 05/31/26
SOC (Billable)
SOC (Pending) HABBI, MARIA
NPI: 1770991713
04/02/2026 METOYER, LINDA
MRN: 900011009
04/02/26 - 05/31/26
SOC (Billable)
SOC (Submitted) AGUINALDO, JANICE
NPI: 1174992085
04/03/2026 JIMENEZ, ANTONIO
MRN: 900011010
04/03/26 - 06/01/26
SOC (Billable)
SOC (Pending) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
04/07/2026 GROSS, MYRA
MRN: 900002883
04/07/26 - 06/05/26
REC (Billable)
REC (Pending) ROC (Pending) DIXIT, SHANKER
NPI: 1477558674