Requirements to comply with the 3L Clinical Coverage Policy
Annually, all enrolled Personal Care Services (PCS) providers authorized to render PCS must attest to their compliance with Clinical Coverage Policy 3L, Section 7.7, Internal Quality Improvement Program. Each provider must sign the Quality Improvement Attestation Form titled NC Medicaid 3136 on or before December 31 of each calendar year. Instructional guidance can be accessed using the form NC-Medicaid 3136 I.
Upon the completion of the attestation form, each provider must upload that form to the QiRePort portal. NC Medicaid will use the QiRePort portal to audit provider compliance with Section 7.7. All providers are required to use that portal to submit their signed attestation.
As required by Session Law 2013-306, for all beneficiaries seeking additional hours authorized under Session Law 2013-306, the authorized provider must submit a Session Law 2013-306 PCS Training Attestation Form titled NC Medicaid 3085 before serving these beneficiaries. The completion of this attestation form confirms their aide training curriculum has been completed and the provider is qualified to support beneficiaries approved for additional hours. This attestation is only required when additional hours are being requested. Providers meeting this qualification will only need to upload this form once time in the QiRePort Portal. Instructional guidance can be accessed using the form NC Medicaid-3085 I.
Instructions to electronically upload Forms 3136 and 3085 using the QiRePort Portal
At the PI Setup Menu:
- Click “Documents” and find your Provider Name/NPI#. (Note: Only providers with administrative rights will have access to the Setup menu to add the forms.)
- Select the Provider Name hyperlink, then select “Add Document,” which will bring up the “Upload Record” screen.
- From there, select Document Type, Document Year and the Record. (Note: The NC Medicaid 3136 and/or 3085 forms(s) must first be saved to the computer or an external device to complete the upload.)
- Select “Done” and the system will place the uploaded document into the Provider Documents table for storage.
- Select “Save” to save the record and complete the upload.
Important information you need to know:
- Only individuals at the provider agency authorized with administrative rights can upload the Forms 3136 and 3085
- Forms 3136 and 3085 are uploaded for each provider and are not beneficiary specific.
- Forms 3136 and 3085 are stored and maintained in the QiRePort portal.
Resource and Technical support:
For any questions on the administrative rights, documentation upload, or any other issues regarding the QiRePort Portal please contact VieBridge Support at 888-705-0970.
For PCS Questions please contact NC Medicaid at PCS_Program_Questions@dhhs.nc.gov, or 919-855-4360.
PCS webpage: https://medicaid.ncdhhs.gov/providers/programs-and-services/long-term-care/personal-care-services-pcs
NCLIFTSS webpage: https://ncliftss.acentra.kepro.com/.