Request for WITS Access for Providers in Indiana
This form allows ATR-certified organizations in Indiana to request access to the WITS system for their staff. It is essential for managing services and billing for ATR clients. Ensure all necessary details are provided to facilitate a smooth request process.
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How do I fill this out?
To fill out this form, start by providing the full name and contact information of the staff member needing access. Next, indicate the type of request – whether it's to add, change, or remove access. Finally, ensure the form is signed by the senior manager before submitting it.
How to fill out the Request for WITS Access for Providers in Indiana?
1
Provide full name of the person needing access.
2
Fill in work and other relevant telephone numbers.
3
Enter the email address of the staff member.
4
Specify the facilities where the staff will work.
5
Sign the form and submit it as directed.
Who needs the Request for WITS Access for Providers in Indiana?
1
Administrative staff who manage client access to necessary systems.
2
Case workers needing data entry capabilities for client records.
3
Billing personnel who require access to billing information.
4
IT support staff who maintain the WITS system.
5
Senior managers overseeing ATR efforts and compliance.
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What are the instructions for submitting this form?
To submit the WITS Access Request Form, please complete all fields accurately. Send the filled form via email to Rachael Pierce at rachael.pierce@fssa.in.gov. It's important to ensure that the form is signed by the senior manager to validate the request.
What are the important dates for this form in 2024 and 2025?
Important dates for WITS form submissions can vary based on ATR guidelines. Typically, annual certifications and access requests should be submitted at the start of each fiscal year. It’s advisable to check with your ATR county contact for specific deadlines relevant to your organization.
What is the purpose of this form?
The primary purpose of the WITS Access Request Form is to facilitate proper access to the WITS system for staff members of ATR-certified organizations. This access ensures that personnel can enter and manage the services and billing information of ATR clients effectively. It also helps maintain data accuracy and compliance with program requirements.
Tell me about this form and its components and fields line-by-line.
- 1. Name of organization: The legal name of the organization requesting access.
- 2. Name of organization's senior manager for ATR: Full name of the senior manager overseeing ATR operations.
- 3. Type of request: Checkbox options to indicate whether access is being added, changed, or removed.
- 4. Name of person needing access: Full name of the staff member for whom access is requested.
- 5. Work telephone number: Contact number for the staff member, including extension.
- 6. Other telephone number: Additional contact number if available.
- 7. E-mail address: The email address of the staff member needing access.
- 8. Facilities where working: List of facilities where the staff member will be working.
- 9. Date of ATR training: Date when the staff member completed ATR training.
- 10. WITS permissions: Checkbox options indicating the desired permissions for WITS access.
- 11. Signature of manager: Signature of the senior manager approving the request.
- 12. Date: The date on which the form was completed.
What happens if I fail to submit this form?
If the form is not submitted, staff members will not receive the necessary access to the WITS system. This could hinder their ability to manage client information and services efficiently.
- Access Denial: Staff will be unable to enter or edit any client data, leading to potential disruptions in service delivery.
- Billing Issues: Failure to submit access requests could result in billing inaccuracies and delays.
- Compliance Risks: Not having staff properly authorized may lead to compliance violations with ATR regulations.
How do I know when to use this form?
- 1. New Staff Access: When onboarding new employees who will utilize the WITS system.
- 2. Access Modification: To adjust permissions for current staff based on their role changes.
- 3. Terminate Access: To revoke system access when staff members leave the organization or change roles.
Frequently Asked Questions
What is the purpose of the WITS Access Request Form?
This form is used to request access to the WITS system for staff members at ATR-certified organizations.
Who should fill out this form?
The senior manager or designated personnel at the ATR-certified organization should complete this form on behalf of the staff needing access.
What information do I need to provide?
You will need to provide the full name, email address, work phone number, and the type of access requested for each staff member.
How do I submit the form?
Once completed, the form should be emailed to the designated ATR contact person provided in the instructions.
Can I make changes to the form after submission?
If changes are needed, please follow the instructions for changing access listed in the form.
What happens if I do not submit the form?
Failure to submit the form may result in staff members not having the necessary access to the WITS system, affecting service delivery.
Is there a submission deadline?
While there is no specific deadline, timely submissions are recommended to ensure your staff can access necessary resources promptly.
Can I submit this form online?
The form should be submitted via email as directed in the instruction section.
Is training required for WITS access?
Yes, individuals needing access must have completed the ATR training to ensure proper understanding of the system.
Who can I contact for questions regarding the form?
For questions, please contact your ATR county contact person listed in the instructions.
