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PCA Provider Checklist

  1. Participate in MN Department Of Human Services "Steps For Success" program (offered three times per year).
  2. Register your home care business through the Minnesota Secretary of State.
  3. Obtain Federal  Tax ID Number (IRS), State Tax ID Number.
  4.   Obtain Liability Insurance,  Worker Compensation Insurance, Fidelity Bond and Surety Bond.   
  5.   Pay application fee (currently $569.00).
  6.   Complete PCA Provider Application including the name and license number of the Qualified Professional you have on staff. 
  7.   When application is approved, you will receive a "Welcome Letter" from the Department of Human Services (DHS) with your Provider Number.
  8.   Send person in charge of billing to state training (offered monthly).
  9.   You will need a Policies and Procedures manual  which explains compliance with all state regulations.
  10.   You will need forms to document your business and the services you provide to each client.
  11. Prepare to hire PCA employees.
  12. Accept clients to your PCA company.
  13. Establish billing system with MNITS (state payment system).
  14. Schedule PCAs to provide care for your clients.

Comprehensive License Checklist

  1.   Register your home care business with the Minnesota Secretary of State.
  2.   Obtain Federal  Tax ID Number (IRS), State Tax ID Number and, optionally, NPI number.
  3.   Obtain Worker Compensation insurance.  
  4.   Complete the application forms and attach required agency specific policies as listed on the application.  NOTE: Must have Registered Nurse named on the application.
  5.   Send check for $4200.00 made out to "MN Department of Health" with your completed application.
  6.   Background studies will be done on all owners and managers once the application is received.
  7.   License will be issued within 90 days of submitting a completed application.
  8.   Notify MN Department of Health within 5 days after admitting first client.
  9.   License will be temporary for one year.  You will receive a permanent license after successful completion of the survey for compliance.
  10. Note:  Cannot apply for Medicare Certification with a temporary license.

245D License Checklist

  1. Register your home care business with the Minnesota Secretary of State.
  2. Obtain Federal  Tax ID Number (IRS), State Tax ID Number.
  3. Obtain Worker Compensation  insurance. 
  4. Complete the 245D Pre-Application worksheet. Be sure to click on "Applicant Agreement and Verification and Affidavit of Authorized Agent " in Step 10. C to download the form.  Fill it out and have it notarized
  5. Apply for 245D License from DHS online or contact us to apply for you once Steps 1, 2 and 3 above are completed.  (There is a consultation fee for this.) The License cost is $500.00.
  6. When license is approved, one must get liability insurance and complete Provider Enrollment (Cost is $586.00) to be eligible for payments for providing services.

Basic License Checklist

  1.   Register your home care business with the Minnesota Secretary of State.
  2.   Obtain Federal  Tax ID Number (IRS), State Tax ID Number and, optionally, NPI number.
  3.   Obtain Worker Compensation insurance.
  4.   Complete the application forms and attach required agency specific policies as listed on the application.  
  5.   Send check for $2100.00 made out to "Commissioner of Finance, Treasury Department" with your completed application.
  6.   Background studies will be done on all owners and managers once the application is received.
  7.   License will be issued within 90 days of submitting a completed application.
  8.   Notify MN Department of Health within 5 days after admitting first client.
  9.   License will be temporary for one year.  You will receive a permanent license after successful completion of the survey for compliance.

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