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PCA Provider Checklist
Comprehensive License Checklist
245D License Checklist
Basic License Checklist
PCA Provider Checklist
PCA Provider Checklist
- Participate in MN Department Of Human Services "Steps For Success" program (offered three times per year).
- Register your home care business through the Minnesota Secretary of State.
- Obtain Federal Tax ID Number (IRS), State Tax ID Number.
- Obtain Liability Insurance, Worker Compensation Insurance, Fidelity Bond and Surety Bond.
- Pay application fee (currently $569.00).
- Complete PCA Provider Application including the name and license number of the Qualified Professional you have on staff.
- When application is approved, you will receive a "Welcome Letter" from the Department of Human Services (DHS) with your Provider Number.
- Send person in charge of billing to state training (offered monthly).
- You will need a Policies and Procedures manual which explains compliance with all state regulations.
- You will need forms to document your business and the services you provide to each client.
- Prepare to hire PCA employees.
- Accept clients to your PCA company.
- Establish billing system with MNITS (state payment system).
- Schedule PCAs to provide care for your clients.
Comprehensive License Checklist
Comprehensive License Checklist
- Register your home care business with the Minnesota Secretary of State.
- Obtain Federal Tax ID Number (IRS), State Tax ID Number and, optionally, NPI number.
- Obtain Worker Compensation insurance.
- Complete the application forms and attach required agency specific policies as listed on the application. NOTE: Must have Registered Nurse named on the application.
- Send check for $4200.00 made out to "MN Department of Health" with your completed application.
- Background studies will be done on all owners and managers once the application is received.
- License will be issued within 90 days of submitting a completed application.
- Notify MN Department of Health within 5 days after admitting first client.
- License will be temporary for one year. You will receive a permanent license after successful completion of the survey for compliance.
- Note: Cannot apply for Medicare Certification with a temporary license.
245D License Checklist
245D License Checklist
- Register your home care business with the Minnesota Secretary of State.
- Obtain Federal Tax ID Number (IRS), State Tax ID Number.
- Obtain Worker Compensation insurance.
- 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
- 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.
- 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
Basic License Checklist
- Register your home care business with the Minnesota Secretary of State.
- Obtain Federal Tax ID Number (IRS), State Tax ID Number and, optionally, NPI number.
- Obtain Worker Compensation insurance.
- Complete the application forms and attach required agency specific policies as listed on the application.
- Send check for $2100.00 made out to "Commissioner of Finance, Treasury Department" with your completed application.
- Background studies will be done on all owners and managers once the application is received.
- License will be issued within 90 days of submitting a completed application.
- Notify MN Department of Health within 5 days after admitting first client.
- License will be temporary for one year. You will receive a permanent license after successful completion of the survey for compliance.