New Applicant Enrollment
Importance of New Providers
In order for the Ohio Home Care Program to continue to grow and meet the demands of the consumers it serves, it is important to recruit and maintain qualified providers of care and services. We welcome all new providers to learn all they can about the program and take advantage of the many benefits it offers.
The role of a provider is to work together with Ohiohcp management & staff (including case managers), state officials and others to provide the finest healthcare to consumers enrolled in the Ohiohcp. This is a very important job. For many persons with disabilities, the key to living an independent life outside of an institutional care setting is to have your skills and expertise assist them with their daily living activities. At times, a person with disabilities may find some of these tasks hard to perform on their own due to a limitation. That is why it is critical for you to be an expert in your work.
Types of Providers
Specifically, in the Home and Community-Based Services program, there are generally three types of home care providers: Agency Providers, Waiver Service Providers, and Non-Agency Providers.
I. Agency Providers
Home care agencies are companies that have a Medicaid provider agreement with the Ohio Department of Medicaid and have been issued a Medicaid Provider Number. They must be either Medicare certified or accredited by JCAHO or CHAP. As such, they must provide services according to established standards of practice. They are reviewed periodically to ensure that they are following Medicare guidelines and/or the accreditation standards. Agencies must provide supervision and training of Licensed Practical Nurses and Daily Living Services providers (home health aides). They have liability insurance and their employees are covered under Worker's Compensation and are usually bonded against loss of property. Agencies are the employer of the individuals performing the in-home services. As such, they handle all employment activities including hiring, firing, scheduling, and paying.
JCAHO and CHAP accredited agencies may not provide all service to all consumers. It is necessary to have all agency services authorized by your Case Manager before the services are provided.
Steps to enrollment for Home Health Agencies
II. Waiver Service Providers
Waiver Service Providers are companies that provide the additional services available only to Waiver consumers including: home delivered meals, emergency response systems, supplemental transportation, home modifications, adaptive/assistive devices, adult day health care, out-of-home respite and others. They have a signed Medicaid Provider Agreement with the Ohio Department of Medicaid (ODM) as an established business with a Medicaid provider number. The individuals who deliver meals or install emergency response systems are employees of that business. The management of that business must fulfill all employment responsibilities including hiring, firing, supervising, scheduling and paying. Only approved Medicaid Waiver providers can provide or complete waiver services and all such services must be prior authorized by your Case Manager.
Steps to enrollment for Supplemental Transportation
Steps to enrollment for Other Provider Types
III. Non-Agency Providers
Non-Agency Providers are individuals who are self-employed and have become eligible to provide home care services directly to the consumer. These individuals are responsible for their own billing and taxes. The consumer provides direct supervision for the Non-Agency Providers while Case Management provides some oversight and monitoring. All Independent Nurse Providers must have a current license and adhere to the standards established by the Ohio Nursing Board. Independent Daily Living Aides must have completed a home health aide or nursing home aide training program and competency evaluation. A Non-Agency Daily Living Non-Aide may perform the same tasks as the Daily Living Aide at the direction of the consumer. All Non-Agency Providers must undergo an annual criminal background investigation and performance evaluation as part of Case Management monitoring.
Steps to enrollment for Non-Agency Personal Care Aide
Steps to enrollment for Non-Agency Licensed Prac. Nurse
Steps to enrollment for Non-Agency Registered Nurse
Know the Rules
As a new provider it is important for you to become familiar with the rules, regulations and rights associated with the program. Please take the time to review them. Most of these can be found in the Info Center.