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Welcome to the Pennsylvania (PA) Department of Human Services (DHS)

Medical Assistance (MA) and Children's Health Insurance Program (CHIP) On-line Provider Enrollment Application

In order for providers to participate with the Department of Human Services, they must first enroll. To be eligible to enroll, practitioners in Pennsylvania must be licensed and currently registered by the appropriate state agency. Out-of-state practitioners must be licensed and currently registered by the appropriate agency in their state and they must provide documentation that they participate in that state’s Medicaid and/or CHIP program. Other providers must be approved, licensed, issued a permit, certified by the appropriate state agency, or if applicable certified under Medicare.

To enroll, providers can complete an on-line provider enrollment application and supply any required supporting documentation. This includes providers who are not billing PA Medicaid or CHIP but provide services to beneficiaries. All applications will be screened based on Federal and State guidelines prior to an enrollment decision. Please retain copies of your application materials for your records. You will receive a response upon approval or denial of your enrollment with PA Medicaid and/or CHIP.

Types of Provider Enrollment Applications
There are three types of enrollment applications and each requires a provider to complete an entire application. Please click the appropriate navigation item on the left hand side of the page to start a “New Application”, “Revalidation” or “Reactivation”.

  • "New Application" - A new service location address or a brand new provider never enrolled with PA Medicaid and/or CHIP
  • "Revalidation" - An active service location for a provider currently enrolled with PA Medicaid and/or CHIP that requires verification of information per Federal or State regulation
  • "Reactivation" - Activating an enrolled service location that is currently closed with PA Medicaid and/or CHIP

Provider Application Fee
The Affordable Care Act requires states to collect an application fee, if applicable, prior to executing a provider agreement from a prospective or re-enrolling provider. Refer to 42 CFR 455, Subpart E – Provider Screening and Enrollment, Section 455.460 for the complete regulation. The Centers for Medicare & Medicaid Services (CMS) sets the amount of the application fee every year.

Providers may request a hardship exception to the application fee requirement. If an exception is requested, the provider will be prompted to submit (upload) documentation. CMS will determine whether or not to grant the hardship exception and communicate the information back to the department. The department will notify the provider of the CMS’ decision.

To pay an application fee, providers must enroll and revalidate through the Electronic Provider Enrollment Application.

The department will assess and collect one fee for multiple applications submitted by one provider in a 7 day time period. Providers who wish to submit multiple applications (for multiple service locations) and pay one fee should use the "Initiate Additional Application" feature and submit all applications within 7 days.

For more information about the application fee, please see the ACA Enrollment Application Fee Medical Assistance Bulletin. For CHIP providers, please contact your designated CHIP Managed Care Organization(s).

Fingerprint-based Criminal Background Checks
Providers assigned to the "high" categorical risk level are required by the Affordable Care Act to obtain fingerprint-based criminal background checks, which include a Federal Bureau of Investigation (FBI) criminal background check and a Pennsylvania State Police Criminal Record Check. In addition, any person with a 5% or more direct or indirect ownership interest in the "high" risk provider must also submit fingerprint-based background checks. Refer to 42 CFR 455, Subpart E – Provider Screening and Enrollment, Section 455.434 for detail on the regulation.

For more information about the Fingerprint-based Criminal Background Checks and criteria used to assign a provider to the "high" categorical risk level, please see the Implementation of Fingerprint-based Criminal Background Checks for Providers Assigned ACA Categorical Risk Level of High Medical Assistance Bulletin. For CHIP providers, please contact your designated CHIP Managed Care Organization(s).

Tracking Provider Enrollment Applications
A unique number called the "Application Tracking Number" (ATN) will be assigned when a "New Application", "Revalidation" or "Reactivation" is started. Prior to exiting the application, write down this number and keep it for your records. If you need to access the application later, please click the appropriate navigation item on the left hand side of the page to "Resume Application" or to check the "Application Status". Note: Information will not be retained and the application will be deleted if the provider does not complete the application, supply the required supporting documentation and click the "Submit Application" button on the "Summary" page when finished.

Additional Information
The following menu bar options will open a web page in a new browser window so information can be viewed while continuing with the application. Please click the appropriate heading at the top of the page to obtain additional information.

  • "Enrollment Information"
    • "Medical Assistance (MA)" - Opens the DHS website provider "Enrollment Information" page
    • "Children's Health Insurance Program (CHIP)" - Opens the "CHIP Provider Enrollment Information" page
  • "Contact Information"
    • "Medical Assistance (MA)" - Opens the DHS "Contact Information/Help for MA Providers" page; includes telephone number and address information
    • "Children's Health Insurance Program (CHIP)" - Opens the "CHIP Provider Enrollment Information" page
  • "Help" - Opens the document that provides navigation tips for the on-line provider electronic enrollment application.
If you have any questions about completing an application, please refer to “Contact Information” and call the appropriate toll free number for your provider type.

System Requirements
At a minimum this site requires Microsoft Internet Explorer version 11 with 256 bit encryption. All enrollment attachments must be uploaded in Adobe PDF format. You must have a copy of Adobe Acrobat Reader installed on your system to view certain supporting documents.

Sours: https://provider.enrollment.dpw.state.pa.us/

Pennsylvania Low Income Home Energy Assistance Program (LIHEAP)

Low Income Home Energy Assistance Program (LIHEAP) is a federally-funded program that helps low-income households with their home energy bills. LIHEAP can help you stay warm in the winter and cool in the summer. By doing so, you can reduce the risk of health and safety problems (such as illness, fire, or eviction).

The Pennsylvania LIHEAP program may be able to offer you one or more of the following types of assistance:

  • Bill payment assistance.
  • Energy crisis assistance.
  • Weatherization and energy-related home repairs.

Low Income Home Energy Assistance Program (LIHEAP) is a federally-funded program that helps low-income households with their home energy bills. LIHEAP can help you stay warm in the winter and cool in the summer. By doing so, you can reduce the risk of health and safety problems (such as illness, fire, or eviction).

The Pennsylvania LIHEAP program may be able to offer you one or more of the following types of assistance:

  • Bill payment assistance.
  • Energy crisis assistance.
  • Weatherization and energy-related home repairs.
Sours: https://www.benefits.gov
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LIHEAP-Crisis-UESF Grants

Crisis Assistance

Crisis Assistance is a federal grant that is awarded to income-eligible customers who are either without utility service or have received a 10-day shut-off notice. Customers can apply for both Crisis Assistance and LIHEAP benefits at the same time. The application deadline for Crisis Assistance is April 9, 2021 or until funds run out. 

Crisis Assistance applications can be taken to one of our six Customer Service Centers or to a Pennsylvania Department of Human Services Crisis Intake Site. To locate the site nearest you or find out if you are eligible, call 215-560-1583 or visit the Pennsylvania Department of Human Services (formerly known as Pennsylvania Department of Public Welfare).

 

UESF

The Utility Emergency Services Fund (UESF) grant is designed to pay off the balance of a customer’s unpaid utility bill and bring it to zero. UESF depends on individuals, corporations, foundations and government agencies to help provide direct assistance to vulnerable families and sustain its operations.

Please consider supporting UESF. All donations made to Utility Emergency Services Fund are tax deductible contributions. To donate, visit https://co.clickandpledge.com/?wid=79325

How to Apply for UESF

UESF is a privately funded grant available to income-eligible customers who are behind on their utility bills. It is offered when no other federal aid is available.

The UESF grant is designed to pay off the balance of a customer’s unpaid utility bill and bring it to zero. PGW matches the amount of the UESF grant to accomplish this. If the UESF grant plus PGW’s matching amount do not meet the full balance, the customer is responsible for paying the remaining portion.

The maximum UESF grant amount is $1,500. Customers can apply for grants at designated UESF Intake Sites. Customers are eligible to apply for UESF once every two years.

Sours: https://www.pgworks.com/customer-care/liheap-crisis-uesf-grants

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