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Program Monitoring

Binders - Compliance and Regulations.jpgThe RH Program conducts agency reviews to ensure high-quality reproductive health services are being provided and that clinical practices, policies, and processes are following certification requirements. Our intent is to both determine compliance with requirements and to provide technical assistance. In addition, reviews provide each agency an opportunity to showcase their strengths and best practices. 

Depending on the agency’s certification, reviews are conducted onsite and/or through desk reviews. 

On-Site Reviews

The goals of on-site reviews are to: 

  • Learn more about your clinic(s).

  • Assess compliance with federal and state regulations, and Certification Requirements.

  • Identify areas where your clinic staff may need technical assistance or training.
On-site reviews are conducted over one or two days for AbortionCare and RHCare respectively. The review includes observing clinic operations, interviewing selected staff, conducting chart reviews, and reviewing relevant documents. 

Desk Reviews

The goals of desk reviews are to: 

  • Assess billing and enrollment practices. 

  • Identify areas where your clinic staff may need technical assistance or training.
Desk reviews are conducted every one or two years for CCare and RHCare respectively. The review includes checking enrollment forms and chart notes, to ensure proper enrollment and billing. Desk reviews may also be initiated when indicated by monthly reviews of claims data 


See below for specific schedules, tools, and materials depending on the type of certification – RHCare, CCare, or AbortionCare.


RHCare Clinic Reviews

On-Site Review Materials

RHCare On-Site Review Schedule 

What to Expect – Provides an overview of expectations, review methods, and two-day schedule.

Document Request List – A checklist of policies, processes, plans, and other documents to submit via email at least 2 weeks prior to the on-site review. 

Review Tool  – The tool used by the Nurse Consultants to determine compliance for each certification requirement.

Chart Review Tool – The tool used by the Nurse Consultants to assess the scope and quality of RHCare services provided.

Client Experience Survey, English and Spanish – A new component to the review process to assess client-centered care and clients’ experiences. 

Client Survey Instructions – Instructions on when and how to administer the Client Experience Survey.

Final Report Template – The Final Report will be shared within 30 days of the agency review and includes all findings/results, promising practices, and recommendations.


Enrollment Form and Billing Review Materials


CCare Clinic Reviews

CCare clinic sites are monitored regularly for accurate billing and client enrollment processes. Chart notes must support that visits' main component was contraceptive management and that the appropriate visits level was billed. Enrollment Form information is also reviewed and verified against the eligibility database.

AbortionCare Clinic Reviews

On-Site Review Materials

AbortionCare On-Site Review Schedule 

What to Expect – Provides an overview of expectations, review methods, and a sample agenda.

Document Request List – A checklist of policies, processes, plans, and other documents to submit via email at least 2 weeks prior to the on-site review. 

Review Tool – The tool used by the Nurse Consultants to determine compliance for each certification requirement.

Chart Review Tool – The tool used by the Nurse Consultants to assess the scope and quality of AbortionCare services provided.

Final Report Template – The Final Report will be shared within 30 days of the agency review and includes all findings/results, promising practices, and recommendations.





Charting Guidance

While the RH Program uses the CVR for billing and data submission, the CVR does not substitute for charting. Clients' records must contain information sufficient to justify the diagnosis codes and medical services recorded on the CVR. This resource provides guidance of what chart notes must contain to support how the visit was billed.

Chart Documentation Guidance