Enrolling as a Provider and Providing Services

Benefits of 1915(i)

Conveniently send notifications to 1915(i) staff when new members begin working with a care coordinator, transfer service providers, and when members stop receiving services from your agency using the below options.

• New Member Care Coordination replaces the Care Coordination Request Report. Use this form when a member is new to 1915(i) care coordination and does not yet have a plan of care.
• Transfer of Services - use this Transfer of Services option to notify 1915(i) staff when a new provider has accepted a service referral for transferring services between agencies. You should still use the Service Provider Request form to send referrals and track service denials and acceptances from other provider agencies. 
• Termination of Member Services replaces the Member Discharge Form. You must still provide written notice to members per the Transferring and Terminating Member Services policy (found on this page). 

NOTE: Please enter your email address on all notifications to ensure a copy is emailed to you.