The Attestations maintenance section allows Individual Providers to update true statements regarding licensure, registration, malpractice, certifications and affiliations.
Only Attestation questions previously answered as “No” can be changed to “Yes” in Maintenance. Questions answered “Yes” cannot be changed, with the exception of questions 6d and 8a, which can be changed from “Yes” to “No” after ten years, if needed.
Answer the question on the screen by selecting one of the radio buttons.
If you answer “Yes,” you will be prompted to provide an explanation. There is a 4000 character limit. If you have additional information to attach, there will be an opportunity to upload supporting documentation prior to the final application review and submission.
Instructions for 8a:
Have you had any professional liability actions (pending, settled, arbitrated, mediated or litigated) within the past 10 years? *If yes, provide information for each case.
Answering “Yes” to this question will prompt the user to download and complete the required Malpractice Supplemental Form.
You will be prompted to upload the Malpractice Supplemental Form in the 8.0 Document Upload section.
Answer the question on the screen by selecting one of the radio buttons.
If you answer “Yes”, you will be prompted to provide an explanation. There is a 4000 character limit. If you have additional information to attach, there will be an opportunity to upload supporting documentation prior to the final application review and submission.
Nolo Contendere- A legal term that is also referred to as a plea of no contest.
Special Characters:
The following Special Characters cannot be used in the situations below. Field properties will prevent from typing the below characters in the box.
For First Name, Business Name, Other name (if any): | + \ '
For Last Name field: | + \ ', and numbers are not allowed
For Comment Boxes: < > ^ / ~ ` + | \ \ / ¬ £
For Address fields: | + ( ! @ # $ ^ * ( ) ? / \ " < > & : ; _ )
If you copy and paste an excluded special character, an error message will display after clicking Save & Next
Remove excluded characters from pasted information or uploaded text in the document
Save & Next:
When finished, click Save & Next to save the information and proceed to the next page
Click Back to go to the previous screen without saving
Click Exit to return to the dashboard without saving
Note that if the information is not saved, you will lose the data on the current page