Provider qualification and Enrollment

DHS Electronic Enrollment and Qualification Training for ODP Providers

This training covers new requirements for Licensed and Unlicensed providers seeking to enroll a new site, enroll a new specialty, or revalidate their service location through the Electronic Provider Enrollment User Interface. It also covers the new functions in HCSIS including Registration, Adding Services and Qualification. 

Session recorded on August 28, 2017. 

Session Recording – DHS Electronic Enrollment

Handout – DHS Electronic Enrollment

HCSIS Provider Updates Tip Sheet

FAQs from the DHS Enrollment and Qualification Training for ODP Providers

Administrative Entity Provider Qualification Contact List

Training on Provider Qualification

Webinar Recording June 20, 2017

Changes to the Provider Qualification Process

Provider Documentation Recorded Webinar

DP 1059 PP Presentation (v.1)URL

Provider Qualification Documents

DP 1059 (3-8-23)

DP 1059 Instructions (V.2)

Helpful Tips for completion of the DP 1059

Residential Readiness Overview and Instructions

ODP Readiness Tool 2-16-22

For new applicant providers, this tool cannot be submitted absent receipt of their 120-day certificate made available upon passing their Virtual PAO post-test. The link to complete this tool will be provided as “Next Steps” for new applicant providers in receipt of their 120-day certificate

Webinar – Residential Readiness Tool Tutorial

DP 1061 Provider Closure Notification Form

DP 1061 Provider Closure Notification Form Instructions

DP 1088 – ODP Provider Qualification Form: Adult Autism Waiver

ODP Provider Qualification Documentation Record-ID/A & AAW Fiscal Year 2023-2024 (January 2024)

New Provider Self-Assessment & Guidelines January 2024

Provider Manual–Provider Qualifications 4-9-21

HCSIS ODP Provider Qualification Reviewer Job Aid

Provider Enrollment Documents

HCSIS Provider Updates Tip Sheet

ODP PROMISe Enrollment Tip Sheet

PROMISeā„¢ Provider Practice Relocation Request Form

Instructions – Adding a Specialty to an ODP site Oct. 2022

PROMISeā„¢ Provider Service Location Change Request

New Provider Process

New Applicant Licensing Flowchart 2-1-21

New Provider Applicant Process 12-08-23

Services by Provider Type and Specialty

Specialties with Enhanced Services 2018

ODP Communications

ODP Announcement 23-101: Provider Qualification Process Update

ODP Announcement 24-002: Qualification Process for New Intellectual Disability & Autism (IDA) Provider Applicants Update

Attachment 1 – New Provider Qualification Approval Template 2024

Attachment 2 – New Provider Qualification Additional Information Needed Template 2024

Attachment 3 – New Provider Qualification Not Approved Template 2024