- Step 4

PA IEB reviews your Physician’s Certification Form and Functional

Eligibility Determination.
• PA IEB needs your Physician’s Certification Form and Functional Eligibility
Determination within 86 days of the first in-home visit.
• If your doctor has not sent the certification form after your second in-home visit,
PA IEB calls your doctor and you.
• Once PA IEB has your Physician’s Certification Form and Functional Eligibility
Determination, they review both to find if you qualify.
⊲ If both forms meet program eligibility, PA IEB sends your application to the CAO.

*Please contact our Referral Specialist, Erica Lau: (814) 915-4249 with any questions.