1. Download the Fillable PDF Stand Alone HCBS Plan of Care POC form by selecting the link.
2. The PDF fields are fillable so you will be able to type your information into the fields and the information will be saved when you select the Save or Save As function in Adobe. Please be sure to save the form in a familiar place and if you are using the Save As function; a unique name will help you to identify a particular PDF from others.
3. Once you have completed and saved your Stand Alone HCBS Plan of Care, you may attach the PDF using the Browse button located within the PAS and/or Plan of Care forms.
4. If you wish to upload the completed PDF and attach it to a Case that has already been created, you may use the Upload Document function located at the following locations: Provider Menu -> Submission Options -> Upload a Document. In order to successfully attach your PDF to your case, please enter the following information in the fields on the Upload Document page:
  • a. Form Type: Select LTC/PAS Form from the dropdown list.
  • b. Document Type: Select Plan of Care from the dropdown list.
  • c. Case Tracking Number: Enter your Case Number.
  • d. Use the Attach/Upload Document functions to navigate to your stored, completed Stand Alone Plan of Care PDF and attach the PDF.
  • e. Choose the Submit button to upload and attach your PDF to your case.