Claims/Appeals
CLS Service Tracking
- Sample CLS Tracking Form 1
- Sample CLS Tracking Form 2
- Sample CLS Tracking Form 3
- Self Determination Timesheet/Progress Note
- Personal Care Tracking Form
- CLS Data Sheet Instructions
- SWMBH Clinical Documentation Policy
- Fillable Spec Res CLS & Personal Care Data Sheet
CLS (H2015) documentation must correspond to the specific goals and objectives written in the individual’s most current treatment plan. Personal Care (T1020) documentation must correspond with the level of assistance for each task identified by the individual’s 3803. Medicaid will not pay for these services unless properly documented.
Incident Reporting
Please ensure your Summit Pointe customer incident reports are completed fully, including supervisor signature, and sent within 24 hours to our team at this fax number: 269-425-3015 or via encrypted email to #performanceimprovement@summitpointe.org
Due to the private nature of an incident report and the need to protect personal health information, the incidents should never be sent to the tech team or to individuals or entities outside of Summit Pointe.
- Blank Incident Report Fillable
- Specialized Residential Incident Report Fillable
- Emergency Use of Physical Management
- Event Reporting Codes
- Incident Reporting Training