FAQs - Provider Services

1. How do I learn about the requirements and responsibilities of being a Waiver provider and download an application?
   
2. How long does it take to become a Home Care Waiver provider?
   
3. I know I need a BCII background and fingerprint check. Where do I get one?
   
4. What happens to my BCII report after I complete the check?
   
5. Is there a video I can watch to help me learn about the requirements of being a Waiver provider?
   
6. Is there a Provider Orientation Class I can attend?
   
7. Where can I find the Ohio Administrative Code (OAC) rules?
   
8. I am a new provider. How do I find consumers to work within the Waiver program?
   
9. What are the benefits of registering as an authorized Provider with http://www.myohiohcp.org?
   
10. Do I have to be certified as a Provider to work with consumers in the Home Care Waiver program?
    
11. Are there other non-certified options form me as a provider?
    
12. If I am a registered provider, am I an employee of CareStar?
    
13. Does CareStar verify employment?
    
14. When will Independent Providers be able to serve Passport clients?
    
15. I am an Ohio Independent Provider required to complete twelve (12) hours of continuing education. Where can I obtain this continuing education?
    
16. Can I be a Nurse Provider in Ohio even if I live in another state?
    
17. How do I view my remittance/pay stubs?
    
18. What websites can I use to find out how to pay my federal, state, & city taxes, social security , etc? What are the percentages that need to be taken out for each of these?
    
19. Where do I find out information about the Union?
    
20. How do I obtain my tax information such as the 1099 form so I can file my federal, state and local income taxes?
    
21. What are the starting wages for the different non-agency provider types?
    
22. Do I need to take CPR & First Aid in order to become a Non-Agency Provider?
    
23. Where can I find these courses to complete?
    
24. How do complete my own billing instead of using a billing company?
    
25. I have moved. I got married/divorced. How do I change my name, address or other information?
    

Q. How do I learn about the requirements and responsibilities of being a Waiver provider and download an application?
A. Go to http://www.ohiohcp.org Under the ‘Become a Provider’ section, click on ‘Provider Application.’ Read the complete all sections of the 27 page application very carefully making sure you are checking your provider type accurately. Mail the application to the address provided. ODJFS will process your application and if approved, send you a letter with your newly issued Provider authorization number.

Q. How long does it take to become a Home Care Waiver provider?
A. It generally takes 45-90 days for ODJFS to process an application. You can always contact ODJFS to check on the status of any submitted application by calling 614-466-6742 asking for the Application Coordinator.

Q. I know I need a BCII background and fingerprint check. Where do I get one?
A. There are numerous locations throughout the state that offers a background check service. There are disqualifying criteria that you should learn before making application to work as a provider. To get information on fingerprints or background checks, call BCII at: Toll-free at (877) 224-0043. Sometimes you will have to follow up and be sure the BCII has forwarded your report to ODJFS and possibly send another copy.

Q. What happens to my BCII report after I complete the check?
A. Background checks must be sent directly to ODJFS from BCII.
Results may not be sent to the provider and forwarded by the provider to ODJFS.

Ohio Department of Job and Family Services
ATTN: BCII Coordinator
Bureau of Community Services Policy
P.O. Box 182709, 5th Floor
Columbus, Ohio 43218-2709

Q. Is there a video I can watch to help me learn about the requirements of being a Waiver provider?
A. YES! A Provider video is available to watch at http://www.ohiohcp.org This video is approximately 30 minutes long and includes information about application, submitting reimbursement claims (billing), creating and retaining your consumer documentation (paperwork).

Q. Is there a Provider Orientation Class I can attend?
A. YES! Every new Provider is strongly encouraged to attend a FREE Provider Orientatin Class. This class is held each month in the CareStar Columbus and Cleveland offices. The address for these locations can be found at http://www.carestar.com You must register for this class presented live and in-person by calling Karen at 800-423-1046 ext. 3107.

Q. Where can I find the Ohio Administrative Code (OAC) rules?
A. The (OAC) rules can be found at http://emanuals.odjfs.state.oh.us/emanuals. There is a link to these rules from the public web site (www.ohiohcp.org) as well. Rules 5101:3-46-04, 5101:46-06, 5101:3-45-10, and 5101:3-45-06 are a few rules you may want to review.

Q. I am a new provider. How do I find consumers to work within the Waiver program?
A. HIPAA laws prohibit Carestar from releasing the names of any consumers. It is not impossible but much more difficult to find a consumer if you already don’t have one. The Home Care Waiver is a consumer Driven program and often a consumer knows you and has requested you. A unique website was created to assist all providers participating in the Home Care Waiver to display their professional profile, availability, and specific geographic location(s) to work. This FREE website is http://www.myohiohcp.org for everyone to view is capabilities but only providers issued an authorized number by ODJFS can register for an account.

Q. What are the benefits of registering as an authorized Provider with http://www.myohiohcp.org?
A. www.myohiohcp.org is a unique website that organizes all your important Ohio Home Care Waiver program information onto one private, individualized page. It includes important records, forms, tools, surveys, news and updates, contact information and more. CareStar Case Managers and Waiver Consumers access this site to find providers throughout the entire state. The written All Services Plan (ASP) is accessible through this site when you have a consumer and you need to verify all hours, duties, and billing information.

Q. Do I have to be certified as a Provider to work with consumers in the Home Care Waiver program?
A. NO. If you are not certified, there is an option called the Consumer Specific Trained Option (CSTO) in which a specific consumer ‘trains’ you to meet the specific needs of that one and only consumer. If you are trained as a CSTO, this is applicable for that one consumer ONLY and cannot be duplicated with any other consumer. As a CSTO, every new consumer you work with choosing this option requires that you submit for a new number for approval.

Q. Are there other non-certified options form me as a provider?
A. YES. There is another option called the Other Equivalent Training (OETP). In this option, you must submit all your training documents to the ODJFS and they will determine if your training is sufficient to match State Trained Nursing Assistant (STNA) or Home Health Aide (HHA) and NO Consumer Specific Trained Option (CSTO) will be required.

Q. If I am a registered provider, am I an employee of CareStar?
A. NO! Carestar does not directly employ providers in personal home care assistance. As a registered ODJFS provider, you are a self-employed Independent Contractor. CareStar only employs RN's and licensed social workers for their case management positions. Anyone can go to http://www.carestar.com/our-company/careers/careers-at-carestar to view all available CareStar positions and an on-line application.

Q. Does CareStar verify employment?
A. NO! CareStar does not verify employment. You will have to use your remittance advice and tax forms for verification.

Q. When will Independent Providers be able to serve Passport clients?
A. Concerns were raised about the newly proposed rules allowing Independent Providers to care for Passport consumers requiring the Kasich administration to temporarily remove the proposed rules from consideration. The rules will undergo a new review before recommendation. Stay tuned to the Ohio Department of Aging website for ongoing updates.

Q. I am an Ohio Independent Provider required to complete twelve (12) hours of continuing education. Where can I obtain this continuing education?
A. CareStar offers a very simple option for all Personal Care Aides, Home Health Agencies and Adult Day Center staff to complete their continuing education requirements through an on-line education website called http://carestarlearning.com This is the easiest way to fulfill CEU obligations through the convenience of a web designed program. Many courses are available and CareStar has made these in-services very affordable knowing the restrictive budgets many providers must battle.

Q. Can I be a Nurse Provider in Ohio even if I live in another state?
A. YES. You are able to work as an Ohio Waiver Nurse Provider and reside in another state as long as you hold a valid nursing license in Ohio.

Q. How do I view my remittance/pay stubs?
A. Go to: http://medicaidremit.ohio.gov/default/home.jsf

Q. What websites can I use to find out how to pay my federal, state, & city taxes, social security , etc? What are the percentages that need to be taken out for each of these?
A. It is highly recommended that you consult a tax accountant or visit one of the many tax assistance businesses (i.e. H&R Block). Also, you may find it helpful to visit the Internal Revenue's web site at www.irs.gov

Q. Where do I find out information about the Union?
A. Contact the Provider Union (S.E.I.U) at 800-227-1199

Q. How do I obtain my tax information such as the 1099 form so I can file my federal, state and local income taxes?
A. The Provider Enrollment department at ODJFS sends 1099s ("tax forms") to providers each year. Providers who do not receive a form may contact Provider Enrollment at 800-686-1516.

Q. What are the starting wages for the different non-agency provider types?
A. The reimbursement rates for all provider types are posted in Ohio Administrative Code (OAC) rule 5101:3-46-06, 5101:3-47-06, and 5101:3-50-06. You may access these and other rules at http://emanuals.odjfs.state.oh.us

Q. Do I need to take CPR & First Aid in order to become a Non-Agency Provider?
A. Applicants must show proof of attending a basic first aid course as part of the application process. After becoming a provider, PCAs must obtain 12 contact hours, annually. CPR First Aid may be included in the contact hours but the course can not be solely internet-based.

Q. Where can I find these courses to complete?
A. There are many sources for providers to fulfill the requirement for courses and contact hours. CareStar does not make direct referrals or recommendations to any specific program. CareStar Learning (http://www.carestarlearning.com) is one option for obtaining contact hours on a variety of topics. Providers may research local hospitals, American Heart Association, American Red Cross, and similar organizations for first aid/CPR and other course offerings as well.

Q. How do complete my own billing instead of using a billing company?
A. To submit claims self as a Waiver provider without use of an approved tape vendor (Billing Company):

Go to https://webmail.carestar.com/exchweb/bin/redir.asp?URL=http://www.jfs.gov

Click on "Ohio Medicaid" (bottom right square)

Click on "Providers" (center of page at bottom)

Under "Other Resources" (bottom right), click on the 2nd to last bullet, "Medicaid Provider Portal"

Once on the "Medicaid Provider Portal", there are two (2) tabs -"home" and "sign-in"

Click on the "sign-in" tab

On next screen, enter user name: 7-digit provider number and password: last 4 digits of SS# (or taxID , if agency)

Then create a new password in the next screen (remember your "current password" will be the 4 digit number entered above)
After registering, go back to the "Medicaid Provider Portal" page and you will see other tab options("home", "sign-in", "remittance advices", "claims submission"

Click on the "Claims submissions" tab to see claims form. Instructions are in upper right-hand corner of page (print these instructions).

If you need help, contact the training team at 1-614-752-9551 (ask for the Ombudsman dept)

Q. I have moved. I got married/divorced. How do I change my name, address or other information?
A. If you have an account on the www.myohiohcp.org website, you have the ability to update your personal information on your own at anytime. If you DO NOT have an account on this website and you have a name change due to marriage or divorce, you must send a copy of the legal document to CareStar for updating. For simple address, phone, email updates, this information can be mailed or faxed to Carestar at 614-751-7770 for updating in the database.