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How do I fill this out?
To fill out this timesheet, first gather the necessary employee information. Next, record the daily in and out punch times accurately. Finally, certify the timesheet by obtaining required signatures.

How to fill out the FA Employer Agent Program Bi-Weekly Timesheet?
1
Gather the employee's details and payroll information.
2
Enter the in and out punch times for each day.
3
Calculate the total hours worked for the pay period.
4
Certify the timesheet by signing and dating it.
5
Submit the completed timesheet according to your employer's guidelines.
Who needs the FA Employer Agent Program Bi-Weekly Timesheet?
1
Employers managing payroll for employees working under Medicaid guidelines.
2
Employees who need to accurately report their work hours for pay.
3
Payroll departments responsible for processing employee timesheets.
4
Accounting services assisting with payroll calculations.
5
Home healthcare agencies submitting hours worked for Medicaid reimbursement.
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What are the instructions for submitting this form?
Submit the completed bi-weekly timesheet to your payroll department via email at payroll@company.com. Alternatively, you can fax it to (844) 727-7533. If available, you may also use the online submission portal provided by your employer for direct uploads.
What are the important dates for this form in 2024 and 2025?
For 2024, ensure all timesheets are submitted by the end of each bi-weekly payroll period. Critical submission dates include January 15, January 29, February 12, and so on for each bi-weekly cycle. For 2025, similar dates need to be meticulously adhered to for compliance.

What is the purpose of this form?
The purpose of the FA Employer Agent Program bi-weekly timesheet is to accurately track and report the hours worked by employees under Medicaid services. This form ensures compliance with regulatory requirements and provides transparent documentation for payroll processing. It serves as an official record that protects both the employer and employee in the event of any discrepancies.

Tell me about this form and its components and fields line-by-line.

- 1. Employer Number: A unique identifier assigned to the employer for payroll purposes.
- 2. Employee Name: Full name of the employee whose hours are being recorded.
- 3. In/Out PUNCH: Fields to log the start and end times of employee shifts.
- 4. Total Punch Hours: Calculated total hours worked based on in and out punch times.
- 5. Employer Signature: Signature of the employer or agent certifying the hours worked are accurate.
What happens if I fail to submit this form?
Failing to submit this timesheet can lead to discrepancies in payroll processing and potential issues with Medicaid compliance.
- Delayed Payroll: Unable to process payroll without the submitted timesheet.
- Compliance Risks: Non-compliance with Medicaid regulations can lead to audits.
- Employee Dissatisfaction: Employees may face financial issues if their hours are not reported.
How do I know when to use this form?

- 1. For Regular Payroll Submission: Use this form to report work hours for timely payroll processing.
- 2. For Medicaid Compliance: Ensure accurate documentation of hours worked under Medicaid guidelines.
- 3. For Employee Record Keeping: Helps in maintaining employee records of hours worked.
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