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(614)355-5560
Central Region
August 27, 2024
Proof Forms Now Available For Primary Care Providers

The Provider incentive Program (PIP) Proof Forms are now available on the PFK Provider Portal for a limited time.  These dashboards display missed opportunities in relation to the 2023 PIP in the form of lists of non-compliant patients for each incentivized metric.  Partners For Kids understands that some of the patients on the lists may have received incentivized services but were not identified in PFK claim data.  Practices can verify the claim data by referencing the individual dashboards (W30-15M, W30-30M, WCV, LSC, and IMA) and submitting appropriate proof to PFK.

Accepted forms of proof include explanations of payment (EOPs) from an insurance company or a Health Care Financing Administration (HCFA) form that show appropriate incentivized activity occurring within the correct timeframe.

Please note that Proof Forms are due in two separate batches:

  • By 9/30/2024: WCV 0 -15 Months, WCV 15-30 Months, WCV 3-6 years, and Lead Screenings
  • By 11/1/2024: WCV 7-11 years, WCV 12-20 years, and Immunizations for Adolescents (IMA)

Lists and materials may be emailed to your provider relations specialist or faxed to 614-355-3185.  Accepted proof forms will be included on the November / December 2024 incentive check.

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