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Tags Posts tagged with "Documentation of Medical Evaluation"

Documentation of Medical Evaluation

The Bureau of Human Services Licensing (BHSL) has received a small number of reports of issues with faxing the updated Documentation of Medical Evaluation (DME) forms. These reports indicate that some fax machines cannot pick up the contrast in the grey shaded areas. You will find both DME forms with the grey areas lightened significantly. These forms are also being added to the BHSL website.

Please note, BHSL has fax-tested both versions of these forms and did not encounter any issues. Issues with faxing may be related to the age/condition or settings of individual fax machines. Online faxing services that do not require the use of a fax machine are widely available, as are alternative methods of form transmission, such as in-person drop off, email, online drop boxes, or the United States Postal Service.

Questions about this communication may be sent electronically.

Photo by Markus Winkler on Unsplash

The Bureau of Human Services Licensing (BHSL) has made an additional update to the Documentation of Medical Evaluation (DME) forms. In Section 10, “Body Positioning / Movement – Level of Assistance for Ambulation or Transfers,” an option for “none” has been added.

Providers are advised to dispose of any previous versions of the updated forms. The most current versions are located below and will replace the forms on the BHSL website. You can differentiate the forms by looking at Section 10 or by referencing the date at the bottom right corner of each page, which will now be 7/25.

The PCH form is the HS 2136, and the ALR form is the HS 2148. Reminder: These forms must be utilized for all medical evaluations, effective July 1, 2025. The forms may also be used immediately.

Details of the forms were discussed during the June 12 webinar. A recording of the webinar will be posted on the BHSL website.

Additional questions regarding this should sent electronically.