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This document outlines the agreement between the Commonwealth of Pennsylvania and the Provider regarding participation in Pennsylvania's Consolidated and P/FDS Waivers for the provision of services
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How to fill out provider agreement for participation
How to fill out Provider Agreement for Participation in Pennsylvania’s Consolidated and Person/Family Directed Support (P/FDS) Waivers
01
Obtain the Provider Agreement form from the Pennsylvania Department of Human Services website.
02
Read the instructions carefully to understand the requirements for participation.
03
Fill out the provider details section including name, address, and contact information.
04
Provide information about the services you intend to offer under the P/FDS Waivers.
05
Complete the qualifications section, ensuring you meet all provider qualifications.
06
Sign and date the agreement to certify that the information provided is accurate.
07
Submit the completed form to the designated office as specified in the instructions.
Who needs Provider Agreement for Participation in Pennsylvania’s Consolidated and Person/Family Directed Support (P/FDS) Waivers?
01
Any service provider wishing to offer support under the Pennsylvania Consolidated and P/FDS Waivers.
02
Organizations and individuals providing services to individuals with intellectual disabilities or related conditions.
03
Providers seeking reimbursement for services delivered under these waiver programs.
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People Also Ask about
How to apply for waiver services in PA?
Call the PA Independent Enrollment Broker (PA IEB) at 1-877-550-4227. Learn more about Home and Community Based Waiver Services. Tell PA IEB you want to apply for waiver services and schedule your first in-home visit. Read the list of papers you need for the first in-home visit.
How to apply for PA autism waiver?
To obtain an application for Pennsylvania's adult autism programs, individuals can request an AAW application and receive guidance on the next steps in the enrollment process by calling the Bureau of Supports for Autism and Special Populations' toll-free number at 1-866-539-7689.
What is the autism waiver program in PA?
The AAW program is a Medicaid waiver designed to provide community-based services to adults with ASD in Pennsylvania. The program aims to support individuals with ASD in living independently in their communities, reducing the need for institutional care and promoting community integration.
What is a consolidated waiver in PA?
A Consolidated Waiver provides additional resources and supports for Pennsylvanians living with an intellectual disability, developmental disability, or autism. Apply at your County Mental Health/Intellectual Disabilities Office.
What is the Pfds waiver in PA?
The Pennsylvania Person/Family Directed Support Waiver is designed to help individuals with an intellectual disability, autism, or developmental disability to live more independently in their homes and communities and to provide a variety of services that promote community living, including self-directed service models
What is a PA waiver?
The PA Waiver Program provides financial assistance to individuals who require long-term services but wish to receive them in their homes or communities instead of in institutional settings like nursing homes.
What is a CHC waiver in PA?
The Community Health Choices (CHC) Waiver is a managed care program for older adults and individuals with physical disabilities who are dually eligible for Medicare and Medicaid. This can apply to those living in managed care homes or those living independently with long-term services and supports (LTSS).
What is a PA consolidated waiver?
A Consolidated Waiver provides additional resources and supports for Pennsylvanians living with an intellectual disability, developmental disability, or autism. Apply at your County Mental Health/Intellectual Disabilities Office.
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What is Provider Agreement for Participation in Pennsylvania’s Consolidated and Person/Family Directed Support (P/FDS) Waivers?
The Provider Agreement for Participation in Pennsylvania’s Consolidated and Person/Family Directed Support (P/FDS) Waivers is a formal contract that establishes the terms and conditions under which service providers can deliver supports and services to individuals under these waivers.
Who is required to file Provider Agreement for Participation in Pennsylvania’s Consolidated and Person/Family Directed Support (P/FDS) Waivers?
Any organization or individual seeking to provide services and supports under the Pennsylvania Consolidated and Person/Family Directed Support Waivers is required to file the Provider Agreement.
How to fill out Provider Agreement for Participation in Pennsylvania’s Consolidated and Person/Family Directed Support (P/FDS) Waivers?
To fill out the Provider Agreement, providers must complete the application form with accurate information about their organization, services offered, and ensure that all required documentation is attached as specified in the application guidelines.
What is the purpose of Provider Agreement for Participation in Pennsylvania’s Consolidated and Person/Family Directed Support (P/FDS) Waivers?
The purpose of the Provider Agreement is to ensure that providers meet necessary standards of service delivery and to ensure compliance with state and federal regulations while providing services to individuals under the waivers.
What information must be reported on Provider Agreement for Participation in Pennsylvania’s Consolidated and Person/Family Directed Support (P/FDS) Waivers?
The Provider Agreement must report information such as the provider's legal name, address, contact information, types of services offered, qualifications of staff, and any other relevant operational details required by the state.
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