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STEPS TO BECOMING A CERTIFIED WAIVER PROVIDER

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STEPS TO BECOMING A CERTIFIED WAIVER PROVIDER Powered By Docstoc
					    STEPS TO BECOMING A CERTIFIED WAIVER PROVIDER

Ohio Dept of Developmental Disabilities: http://odmrdd.state.oh.us/providers/new.htm


Info link to NEON about becoming an independent provider and required training
https://www.neoncog.org/index.php?option=com_content&view=article&id=7&Itemid=23
For assistance with the application forms and the process, plan to attend Precertification class.
Certification Requirements


    •   Be at least 18 years of age
    •   Hold a high school diploma or GED (Note: Currently certified independent providers and currently engaged
        direct services employees of certified agency providers are exempted from this requirement.)
    •   Have a Social Security card and valid identification
    •   Have a Bureau of Criminal Identification and Investigation (BCII) report
    •   Not be on the Abuser Registry
    •   Not be on the Nurse Aide Registry indicating the Ohio Department of Health has made a determination of
        abuse, neglect, or misappropriation of property of a resident of a long-term care facility or residential care
        facility
    •   Be able to read, write, and understand English at a level sufficient to comply with rules governing the
        services provided
    •   Be able to effectively communicate with the individual served
    •   Hold valid First Aid certification
    •   Hold valid CPR certification
    •   Have completed eight hours of training in: Serving individuals with developmental disabilities,
        Individual rights, Providing HCBS waiver services, Requirements of rule 5123:2-17-02 (Incidents
        Adversely Affecting Health and Safety) and Universal Precautions for infection control



The 8 hour training is available for free:
https://www.neoncog.net/index.php?option=com_content&view=article&id=7&Itemid=23.

Training Classes are also available for a fee on line at:
https://asoft130.securesites.net/secure/oacbmrdd/index.php?src=gendocs&ref=Training+Center+Home&c
ategory=Training+Center&link=Training+Center+Home


Evidence of First Aid and CPR training is required. Training is available through:
American Red Cross: http://www.redcross-cleveland.org/training/
American Heart Association: www.americanheart.org
CPR Ohio: www.cprohio.com.
Shull Medical Educators:


CPR 1st aid Shull
 class announ...
Required application forms:

Form #                    Description
ODJFS-6750                Ohio Health Plan Provider Application/Agreement for Individual Practitioners
OBM-5657                  OBM Vendor Information Form
Form W-9                  Taxpayer Identification Form
(Rev. 10-2007)
HLS-0038                  Request form for the denial of funding or business contract
                          Terrorist Exclusion List

Most Commonly Requested Service Applications
-This is a list of the most commonly requested services. For the complete list of services, go to
http://odmrdd.state.oh.us/providers/new.htm

                          Description
Form #
CERT01                    Provider Certification Application
CERT-02                   Homemaker/Personal Care, Independent/Agency Provider
CERT-03                   Transportation, Independent/Agency Provider
CERT-04                   Transportation Mileage Other Than to Access Adult Day Services,
                          Independent/Agency Provider


BCII criminal background check is required. List of BCII locations is attached:
http://www.ag.state.oh.us/business/fingerprint/data/index.asp
Please ask them to have the results sent to your address and include the results with application
materials.

ODMRDD Certification Unit phone is 1-877-289-3636 for questions about the application. If help is
needed with the application and process, plan to attend Precertification class, which is offered monthly.
Go to the NEON website for the schedule of classes.


Mail application forms, application fee (Money Order or Check), evidence of training, BCII
background check results, copy of Social Security card, copy of High school diploma or GED,
copy of driver's license, and auto insurance (if applying to provide transportation services) to:

OHIO DEPARTMENT OF MR/DD
PROVIDER CERTIFICATION UNIT
30 E. Broad Street, 13th Floor
Columbus, Ohio 43215-3434
Make a copy of everything before mailing.


Upon certification, fax the Initial and Final approval letters to 216-736-4547. Plan to attend New Provider
Orientation class to learn about the required documentation and billing process. Go to the NEON website
for the schedule of training classes.

Questions, please call the Provider Inquiry Line at 216-556-0062 and someone will return your call.




Revised by Aggie Girt, 7/15/10

				
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