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)
10/10/2025 OGLETREE, JANENE
MRN: 900010625
10/10/25 - 11/14/25
SOC (Billable)
SOC (Exported to State) KIDIAVAYI, STANLEY
NPI: 1902290968
KIDIAVAYI, STANLEY
NPI: 1902290968
JM 11/04/25 03:20 PM
exported the form into HAS
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
01/13/2026 WILLIAMS, MARY
MRN: 900010801
01/13/26 - 03/13/26
SOC (Billable)
SOC (Pending) HARUTYUNYAN, ANNA
NPI: 1972930493
01/14/2026 HYATT, SCOTT
MRN: 900010810
01/14/26 - 03/14/26
SOC (Billable)
SOC (Under Review) CHEN, LI-CHIEN
NPI: 1528492949
01/14/2026 RAMOS, YOLANDA
MRN: 900010808
01/14/26 - 01/31/26
SOC (Billable)
SOC (Exported to State) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
JM 02/06/26 03:45 PM
exported the form into HAS
01/14/2026 KEATING, LEE
MRN: 900010803
01/14/26 - 03/14/26
SOC (Billable)
SOC (Reviewed) SAFAEI, SANA
NPI: 1457347304
01/15/2026 DAVIS, HELEN
MRN: 900010717
01/15/26 - 03/15/26
SOC (Billable)
SOC (Under Review)
Missing PCP - please coordinate with (Ron)
01/15/2026 MCKINNEY, MARK
MRN: 900010815
01/15/26 - 01/29/26
SOC (Billable)
SOC (Under Review) PIMSAKUL, TANNER
NPI: 1518426394
01/15/2026 KENNEDY, PAULETTE
MRN: 900010814
01/15/26 - 01/15/26
SOC (Non-Billable)
SOC (Deleted) HEDGER, RONALD
NPI: 1447576632
Patient was marked as Non-Billable. This record 01/15/2026 may no longer be needed.
01/16/2026 BRANAGAN, PAUL
MRN: 900010220
01/16/26 - 01/15/27
REC (Billable)
REC (Under Review) CAPOBIANCO, LEO
NPI: 1063483097
Arnold 01/13/26 09:51 AM
sent form back to Pending
01/16/2026 FULTON, JEANNE
MRN: 900010820
01/16/26 - 03/16/26
SOC (Billable)
SOC (Under Review) NOMAN, AHMAD
NPI: 1275657579
NOMAN, AHMAD
NPI: 1275657579
01/17/2026 RUIZ ORTEGA, FRANCISCO
MRN: 900010811
01/17/26 - 03/17/26
SOC (Billable)
SOC (Under Review) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
01/17/2026 ROSAS PEREZ, RITO
MRN: 900010806
01/17/26 - 03/17/26
SOC (Billable)
SOC (Under Review) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
01/17/2026 PINKNEY, LEVERN
MRN: 900010809
01/17/26 - 03/17/26
SOC (Billable)
SOC (Under Review) THUMMALA, ANURADHA
NPI: 1376552745
THUMMALA, ANURADHA
NPI: 1376552745
01/18/2026 LEVINE, CRAIG
MRN: 900010714
01/18/26 - 03/18/26
SOC (Billable)
SOC (Under Review) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
01/19/2026 SMITH, MARY
MRN: 900008161
01/19/26 - 03/19/26
REC (Billable)
REC (Pending) CHOI, YUK KI
NPI: 1679928535
01/19/2026 MITCHELL, LEE
MRN: 900010827
01/19/26 - 03/19/26
SOC (Billable)
SOC (Under Review) NASIAK, MICHAEL
NPI: 1821076449
NASIAK, MICHAEL
NPI: 1821076449
01/20/2026 ROSA, JOSEPH
MRN: 900010824
01/20/26 - 03/20/26
SOC (Billable)
SOC (Under Review) CHIANG, JIM
NPI: 1306816566
CHIANG, JIM
NPI: 1306816566
01/20/2026 KIRKPATRICK, GEORGE
MRN: 900010828
01/20/26 - 03/20/26
SOC (Billable)
SOC (Under Review) CHINTA, SUNEETHA
NPI: 1720038185
CHINTA, SUNEETHA
NPI: 1720038185
01/20/2026 NOZAKI, KENNETH
MRN: 900010822
01/20/26 - 03/20/26
SOC (Billable)
SOC (Under Review) PHAM, MATT
NPI: 1003917055
PHAM, MATT
NPI: 1003917055
01/20/2026 METZBOWER, BARBARA
MRN: 900010826
01/20/26 - 03/20/26
SOC (Billable)
SOC (Under Review) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
01/22/2026 SANDOVAL, PAULINE
MRN: 900010830
01/22/26 - 01/23/26
SOC (Non-Billable)
SOC (Deleted) JOU, JASMINE
NPI: 1063909877
JOU, JASMINE
NPI: 1063909877
Patient was marked as Non-Billable. This record 01/22/2026 may no longer be needed.
01/22/2026 BIJOLD, GERALD
MRN: 900010571
01/22/26 - 03/22/26
REC (Billable)
REC (Pending) KIDIAVAYI, STANLEY
NPI: 1902290968
01/23/2026 WHITLEY, ANN
MRN: 900008129
01/23/26 - 03/23/26
REC (Billable)
REC (Pending) KIDIAVAYI, STANLEY
NPI: 1902290968
01/24/2026 VAN WINKLE, LORI
MRN: 900010708
01/24/26 - 03/24/26
SOC (Billable)
SOC (Under Review) HAWKINS, SHENAKWA
NPI: 1306384086
HAWKINS, SHENAKWA
NPI: 1306384086
01/24/2026 DIPASQUALUCCI, JUDY
MRN: 900009774
01/24/26 - 03/24/26
SOC (Billable)
SOC (Under Review) ASANTE, KRISTI
NPI: 1811955354
ASANTE, KRISTI
NPI: 1811955354
01/24/2026 JOHN, BERNADETTE
MRN: 900010836
01/24/26 - 03/24/26
SOC (Billable)
SOC (Under Review) KIDIAVAYI, STANLEY
NPI: 1902290968
KIDIAVAYI, STANLEY
NPI: 1902290968
01/25/2026 LOCKMAN, MARIALINA
MRN: 900010677
01/25/26 - 03/25/26
REC (Billable)
REC (Pending) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
01/25/2026 RIVERS, GEORGE
MRN: 900010833
01/25/26 - 03/25/26
SOC (Billable)
SOC (Under Review) GUILLEN, EDELAINE
NPI: 1740065754
GUILLEN, EDELAINE
NPI: 1740065754
01/25/2026 SANDOVAL, PAULINE
MRN: 900010830
01/25/26 - 03/25/26
SOC (Billable)
SOC (Under Review) JOU, JASMINE
NPI: 1063909877
JOU, JASMINE
NPI: 1063909877
01/25/2026 SCHEELER, GAYLE
MRN: 900010840
01/25/26 - 03/25/26
SOC (Billable)
SOC (Under Review) ANG-ERMOCILLA, BEATRIZ
NPI: 1962412106
ANG-ERMOCILLA, BEATRIZ
NPI: 1962412106
01/25/2026 BESHERSE SR, LARRY
MRN: 900010361
01/25/26 - 03/25/26
REC (Billable)
REC (Reviewed) KIM, DAVID
NPI: 1396705661
01/26/2026 FALCO, LENORE
MRN: 900010831
01/26/26 - 03/26/26
SOC (Billable)
SOC (Under Review) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
01/27/2026 MINER, JILL
MRN: 900010839
01/27/26 - 01/30/26
SOC (Billable)
SOC (Under Review) HEDGER, RONALD
NPI: 1447576632
HEDGER, RONALD
NPI: 1447576632
01/27/2026 ZARAGOZA, LAURA
MRN: 900010842
01/27/26 - 03/27/26
SOC (Billable)
SOC (Under Review) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
01/27/2026 RAMEY, CYNTHIA
MRN: 900010829
01/27/26 - 03/27/26
SOC (Billable)
SOC (Under Review) KIDIAVAYI, STANLEY
NPI: 1902290968
KIDIAVAYI, STANLEY
NPI: 1902290968
01/28/2026 GEORGE, RONNIE
MRN: 900010845
01/28/26 - 03/28/26
SOC (Billable)
SOC (Under Review) HEDGER, RONALD
NPI: 1447576632
HEDGER, RONALD
NPI: 1447576632
01/28/2026 PROWS, DONNA
MRN: 900006676
01/28/26 - 03/28/26
REC (Billable)
REC (Pending) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
01/28/2026 STAMS, DION
MRN: 900010847
01/28/26 - 03/28/26
SOC (Billable)
SOC (Under Review) TRAN, DZUNG
NPI: 1275545352
TRAN, DZUNG
NPI: 1275545352
01/29/2026 MACK, LAURENCE
MRN: 900010849
01/29/26 - 03/29/26
SOC (Billable)
SOC (Submitted) ROSENSTEIN, DAVID
NPI: 1518001551
ROSENSTEIN, DAVID
NPI: 1518001551
01/29/2026 FIGUEROA RIVERA, ERASMO
MRN: 900010850
01/29/26 - 03/29/26
SOC (Billable)
SOC (Submitted) COHEN, ANDREW
NPI: 1962410274
COHEN, ANDREW
NPI: 1962410274
01/29/2026 LIPAT, WILLY
MRN: 900010852
01/29/26 - 03/29/26
SOC (Billable)
SOC (Submitted) PARK, JOOBIN
NPI: 1588028807
PARK, JOOBIN
NPI: 1588028807
01/29/2026 RICE TUCKER, BARBIE
MRN: 900010848
01/29/26 - 03/29/26
SOC (Billable)
SOC (Under Review) SAENZ, COURTNEY
NPI: 1376162057
SAENZ, COURTNEY
NPI: 1376162057
01/29/2026 CAGE, DORIS
MRN: 900003278
01/29/26 - 02/02/26
SOC (Billable)
SOC (Under Review) WOLFSON, ERIC
NPI: 1023044773
WOLFSON, ERIC
NPI: 1023044773
01/30/2026 VIOLANTA, EGMIDIO
MRN: 900010013
01/30/26 - 03/30/26
REC (Billable)
REC (Pending) ALONS, JESSE
NPI: 1730851692
01/30/2026 PINEDA, ELEUTERIO
MRN: 900010855
01/30/26 - 03/30/26
SOC (Billable)
SOC (Submitted) MACHUCA, MARIA
NPI: 1154761880
01/30/2026 MCGOWAN, MIKE
MRN: 900010832
01/30/26 - 03/30/26
SOC (Billable)
SOC (Submitted) RAHMAN, SYED
NPI: 1427169986
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
01/30/2026 PARASCANDO, ELIZABETH
MRN: 900010851
01/30/26 - 03/30/26
SOC (Billable)
SOC (Submitted) BETHEA, SYVETTE
NPI: 1740164177
01/31/2026 MATTHEWS, ELJAY
MRN: 900010598
01/31/26 - 03/31/26
REC (Billable)
REC (Pending) SADO, MARIA AGNES
NPI: 1104339225
01/31/2026 SHIPMAN, LINDA
MRN: 900010600
01/31/26 - 03/31/26
REC (Billable)
REC (Submitted) REC (Pending)
Missing PCP - please coordinate with (Marlo)
01/31/2026 BRANAGAN, FRANCESCA
MRN: 900010676
01/31/26 - 03/31/26
REC (Billable)
REC (Submitted) REC (Submitted) DANI, ROOPA
NPI: 1063482180
01/31/2026 HICKS JR, JOHNNY
MRN: 900010862
01/31/26 - 03/31/26
SOC (Billable)
SOC (Submitted) MISHRA, RAGHAVENDRA
NPI: 1982858742
02/01/2026 ALPERT, STEPHEN
MRN: 900010863
02/01/26 - 04/01/26
SOC (Billable)
SOC (Pending) HARRIES, KARYN
NPI: 1376571455
02/01/2026 CROWE, DEBORAH
MRN: 900010858
02/01/26 - 04/01/26
SOC (Billable)
SOC (Submitted) PIMSAKUL, TANNER
NPI: 1518426394
PIMSAKUL, TANNER
NPI: 1518426394
02/01/2026 DELGADO, GLORIA
MRN: 900010823
02/01/26 - 04/01/26
SOC (Billable)
SOC (Pending) BUI, SON
NPI: 1205861820
BUI, SON
NPI: 1205861820
02/01/2026 MENELEY, JEAN
MRN: 900010856
02/01/26 - 04/01/26
SOC (Billable)
SOC (Submitted) CHEN, THOMAS
NPI: 1992875538
CHEN, THOMAS
NPI: 1992875538
02/03/2026 SANTELLAN, ROBERT
MRN: 900010433
02/03/26 - 04/03/26
REC (Billable)
REC (Pending) KIDIAVAYI, STANLEY
NPI: 1902290968
02/03/2026 RUMBOLZ, CAROL
MRN: 900008352
02/03/26 - 04/03/26
REC (Billable)
REC (Pending) HANSEN, LINDSAY
NPI: 1942238860
02/03/2026 MILLER, AUBREY
MRN: 900010859
02/03/26 - 04/03/26
SOC (Billable)
SOC (Pending) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
02/04/2026 HAYES, ATHENA
MRN: 900010838
02/04/26 - 04/04/26
SOC (Billable)
SOC (Submitted) NAVALTA, JULIA VIVIEN
NPI: 1871017400
02/05/2026 GONZALES, RICHARD
MRN: 900010868
02/05/26 - 04/05/26
SOC (Billable)
SOC (Pending) BRYAN, GREGORY
NPI: 1598765984
02/05/2026 TINGLEY, PRISCILLA
MRN: 900010865
02/05/26 - 04/05/26
SOC (Billable)
SOC (Pending) WAGNER, BAILEY
NPI: 1407315393
02/05/2026 VOELCKER, SUSAN
MRN: 900010869
02/05/26 - 04/05/26
SOC (Billable)
SOC (Submitted) MILMAN, ADAM
NPI: 1912021262
02/05/2026 PAYAN, PATSY
MRN: 900007668
02/05/26 - 04/05/26
SOC (Billable)
SOC (Pending) DUNSMOOR, KEVIN
NPI: 1992963664
02/05/2026 DOWNEY, LAURIE
MRN: 15391
02/05/26 - 04/05/26
SOC (Billable)
SOC (Submitted) MARTINEZ, CRYSTAL
NPI: 1881299386
02/06/2026 DOWLING, JAMES
MRN: 900009484
02/06/26 - 04/06/26
REC (Billable)
REC (Submitted) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
02/06/2026 APPLETON HULTZ, KELLIE
MRN: 900010873
02/06/26 - 04/06/26
SOC (Billable)
SOC (Pending) ALFONSO, MARIA JILL
NPI: 1982332227
02/06/2026 TAYLOR, MARTHA
MRN: 900010866
02/06/26 - 04/06/26
SOC (Billable)
SOC (Pending) TORRES-QUIALA, JUNIER
NPI: 1427509850
02/06/2026 SOJOT, WILHELMINA
MRN: 900010872
02/06/26 - 04/06/26
SOC (Billable)
SOC (Pending) MARK, MICHELLE
NPI: 1083024194
02/06/2026 WINNEFELD, NANCY
MRN: 900010870
02/06/26 - 04/06/26
SOC (Billable)
SOC (Pending) DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215