Provider Enrollment - Frequently Asked Questions

How often do I need to have a criminal background check? Only one time, as long as you stay with the same provider agency. If you've switched agencies and the background check is less than one year old, you will not need to obtain your clearance again.

Do I need an Employee Identification Number (EIN) number? EIN is needed only if you have employees.

Do I need a business license? A business license is required for the county or city in which their office is located, even if you are serving in another county or city.

Why do I need Surety Bonding? The Center for Medicaid Medicare Services (CMS), formerly the Health Care Financing Administration (HCFA), and DOH require that all providers be bonded.

Is there a set aggregate amount for General Liability? There is no aggregate amount set, however, $3 million in normally accepted.

How long does the application process take? Upon receipt of a complete application, please allow 8 weeks for completion of the application process, not including issuance of the Medicaid Billing number.

What happens when I receive my Medicaid Billing Number? Once a Medicaid Billing Number is issued, the DOH Provider Enrollment Unit will request Case Managers in the appropriate region to place your provider agency on the Secondary Freedom of Choice (FOC). Newly allocated recipients or recipients wishing to switch direct care providers will receive a Secondary FOC form that is set up by county and service. Your agency name, as well as all other agencies providing that same service in the same county will appear on this form. Your caseloads will be established by recipients selecting your agency.

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