1: Navigate to the tab labeled ‘Files’ located in the upper right-hand corner of the page as shown in the image below.
2: Click the arrow next to the folder labeled ‘KY Medicaid Survey’ to expand and then click the arrow next to the 2022 folder. Here you will find a file titled ‘2023 KY GEMT Revenue Survey Template.pdf’ (see image below). This will be the signature page only that you will need to sign and email.
3: Click on the file to download and save the PDF. This is the document that will need to sign and email. You will find that MCA has already completed the general information tab on your behalf. If you find a discrepancy or error in any of this data (such as the incorrect name of the person certifying the report) you can email firstname.lastname@example.org. Electronic signatures are accepted or you can print, sign and then scan the signed document for submission.
IMPORTANT NOTE: DOUBLE CHECK THE FIELD FOR THE NAME OF THE PERSON CERTIFYING AND SIGNING THE REPORT. THIS IS CARRIED OVER FROM LAST YEAR AND MAY HAVE CHANGED IF YOUR AGENCY HAS HAD ADMINISTRATIVE STAFF CHANGES.
4: You can review the full document before signing off by downloading the .xlsx (excel file) located on the MCA dashboard in the same folder as the signature page (as shown below). If you choose, you can also review all of the source report files that were used to fill out the survey which are located in the same folder.