HFA Application/Presurvey Questionnaire Instructions

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1 Reaccreditatin Survey/Currently Accredited Facility Cnsultatin Survey: Enter the Facility s EIN: This is a nine digit number XX-XXXXXXX. It is als knwn as the Federal Tax ID Number. This can be btained frm the Hspital that yu are affiliated with. The accunting department will have it. If yu are a nn-affiliated facility check with yur internal accunting department. Enter the Passwrd t lgin. Click n yur facility Applicatin Status bx: Click Review Next t Applicatin Pending n the tp line. D nt select Start a New Applicatin. Carefully review the infrmatin we have in the system, Update as needed (Part 1, Part 2, Part 3, Billing Infrmatin). Dwnlad and sign the signature page, uplad it. Print Applicatin and Submit. Review yur Dcument due date, and cmplete the Presurvey Questinnaire. Fllw the instructins belw. crrect facility. If yu enter yur Applicatin/Presurvey Questinnaire/Additinal Dcumentatin are under the wrng lcatin, it will be rejected and yu will have t re-enter it. Accreditatin Survey Applicatin fr New Facilities First Time Survey r First Time Cnsultatin Survey Enter the Facility s EIN: This is a nine digit number XX-XXXXXXX. It is als knwn as the Federal Tax ID Number. This can be btained frm the Hspital that yu are affiliated with. The accunting department will have it. If yu are a nn-affiliated facility check with yur internal accunting department. crrect facility. If yu enter yur Applicatin/Presurvey Questinnaire/Additinal Dcumentatin are under the wrng lcatin, it will be rejected and yu will have t re-enter it. Click start. Yu will be prmpted t prvide infrmatin. Click Ok Accunt Infrmatin- This is where yu will enter yu cntact infrmatin and passwrd. D nt make the username and passwrd specific t yu. It will need t be ne that can be passed n t smene else if yu leave the facility. Set up a file with the WebDirect instructins, passwrd & username. Click n save. `1

2 The Lgin prmpt will appear. Enter passwrd and Lgin. Accreditatin Survey(First time Survey)/Cnsultatin Survey(First Tim Cnsultatin) Click Start a New Applicatin Yu will see the blank applicatin. Check the type f survey and start filling ut the applicatin. When Part 1 is cmplete click cntinue. Use Tab key t mve t next entry. If any infrmatin is missing yu will be prmpted t cmplete. Yu cannt mve t the next page until all infrmatin is entered. Dn t miss checking the Type f Survey at the tp f the Page! * Nte: The Facility Name is the affiliate Hspital Name if applicable. Make sure the Hspital and Hyperbaric Facility Name is exactly the same as the names that will g n the Certificate f Accreditatin Part 2- Cmplete infrmatin Hyperbaric Staff: Specialty examples are, Physician, Nurse, Technician, Safety Directr, and indicate if each is a MD, DO, DPM, NP, CHT, CHRN, ACHRN, CHS, CHWS, enter the number f Full and Part Time. Ex: If n Part Time enter zer. `2

3 Click t cntinue t Part 3. If smething is missing refer t abve. Part 3- Cmplete recmmended Travel Infrmatin, Click t Cntinue Review. Review the infrmatin that is entered. If yu need t make a change use the Back buttn and make the change. D nt use yur web brwser back buttn. Cntinue Billing: Click the radi buttn that applies: Same as Physical r Same as Mailing, and it r if yu are a Managed Facility and they are paying enter their payment infrmatin. Click Payment Type. Once clicked the payment instructins will appear. Dwnlad the Signature page, scan and save t yur cmputer, then uplad the file. This is als where yu dwnlad the applicatin fr yur Files. Once yu have upladed the signature page and printed yur applicatin, Click Clse. Click Submit. Yu will receive a ntificatin that yur applicatin has been received. Please Read. Click Dne. `3

4 A ntificatin will be sent t yu that yur applicatin was apprved. D nt start the Presurvey questinnaire until yu receive ntificatin f the due dates if yu are an Accreditatin r Cnsultatin Survey. Reaccreditatins shuld the prir survey s Accreditatin Letter with the suspense dates fr the Presurvey Questinnaire. If yu d nt knw when yur dcuments are due, please cntact us. *Imprtant Nte: If yu need t stp and cmplete later, yu can. Just clse ut f it, cme back later, pen WebDirect, enter yur EIN, and select yur facility, lgin, click review and pick up where yu left ff. crrect facility. If yu enter yur Applicatin/Presurvey Questinnaire/Additinal Dcumentatin under the wrng lcatin, it will be rejected and yu will have t re-enter it. HFA will ntify yu. If yu did nt print yur applicatin earlier, yu can g back int yur applicatin by Clicking n Review n the Accreditatin Survey Applicatins page, click thrugh each page until yu see the dwnlad buttn and dwnlad it t yur cmputer and print frm where yu saved it. Presurvey Questinnaire D nt start the Presurvey Questinnaire until yu have received ntificatin f the Due Dates fr it. Reaccreditatins shuld the prir survey s Accreditatin Letter with the suspense dates fr the Presurvey Questinnaire. Lgin as listed abve. crrect facility. If yu enter yur Questinnaire under the wrng lcatin, it will be rejected and yu will have t re-enter it. HFA will ntify yu. Click n Questinnaire This screen will appear. Yu can start the questinnaire with Questin 1 r change the sectin t cmplete in any rder yu chse. `4

5 Click n next questin in the bttm right crner If any part f a questin is missing yu will see highlights similar t the infrmatin belw. All highlighted areas will have t be cmpleted. Questin 115, indicate BLS r ACLS d nt put an X Under Specialty, put MD, DO, DPM, NP and s frth. Make sure yu als include CHT, ACHRN, CHRN, CHS, CHWS Questin 193 is the last questin. Click Save and return. The prgress bar in the abve left fills in as questins are answered. If it is nt full after yu enter the last questin, Click n Selectin and change t Unanswered questins. `5

6 Then, yu will nly see the unanswered questins. Once all questins are cmpleted the prgress bar will be slid and all questins will have a check mark. Click Cntinue t Part 2: This sectin is the patient treatment infrmatin. Enter all f yur treatments. If the infrmatin is missing, yu will see areas highlighted. If yur facility has nt been pen fr 3 years and nly 2 NA fr that year. Yu als have the ptin t add ther treatment cdes. After all infrmatin is entered: if any infrmatin is incmplete, the system will nt let yu mve t Part 3. Click Cntinue t Part 3: This sectin is where yu will uplad yur additinal infrmatin that was listed n page 5 f the ld Presurvey questinnaire. Please uplad in all dcuments in PDF. Click the Brwse buttn, then click chse file, find the file yu want t uplad, select the file and click pen. The file name shuld appear next t the Chse file buttn. Click Uplad. `6

7 Cntinue uplading the mandatry dcuments. Nte: Number 10 By-Laws is the nly ptinal dcument. * Imprtant Nte: Befre Clicking the Submit buttn, REVIEW yur Presurvey Questinnaire and dcumentatin! Click the Menu buttn, click Applicatins, Click n Questinnaire t review the Presurvey r Click Dcuments r Treatment Inf t review thse. Once yu have cmpleted yur final review, Click Submit. Once yu submit yu will receive a screen s that yu can dwnlad the Presurvey Questinnaire. Dwnlad this as sn as yu submit it fr yur recrds. Cngratulatins! Yu have cmpleted the Prcess! We lk frward t wrking with yu fr the upcming survey. Click the Menu Buttn t lgut. Yu can always lgin again t have access t yur infrmatin. If yu need help, please cntact Beth Hands , x105 Derall Garrett , x 106 `7

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