District of Columbia Department of Health Care Finance ...

District of Columbia Department of Health Care Finance Provider Data Management System and Service (PDMS) Project

How to Enroll as a PCA/HHA Aide in DC Medicaid using the DC Provider Screening and Enrollment Web Portal

Version 1.4 September 19, 2018

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Revisions Version 1.0

Date 12/14/2017

1.1

12/29/2017

1.2

1/30/2018

1.3

4/9/2018

1.4

9/19/2018

Description

Review and Update Web Portal User Guide or PCA Aide users. Establish Version 1.0 for PCA Aides

Revised and updated with requested changes.

Revised and updated to add clarification on the Alien ID Number, zip code +4 extension, and advising to enter 100 on ownership line.

Revised and updated to add additional steps for providers with a previous PCA provider number already in the PDMS system. Updated format Updated format, screenshots and table of contents.

Author Catherine Bradica Natasha Hudson Venita Stratford

Eugene Eaton

Eugene Eaton

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Table of Contents

Overview ................................................................................................................................................. 4 Creating a User Account .......................................................................................................................... 4 Creating a User Account ? Cont. ............................................................................................................. 5 Creating a User Account ? Cont. ............................................................................................................. 6 Provider Management Home .................................................................................................................................7 New Registration Box ............................................................................................................................ 8 Provider Information .............................................................................................................................. 9 Primary Contact Information ................................................................................................................. 10 Specialties ............................................................................................................................................. 11 Taxonomies ............................................................................................................................................11 Professional Licenses ............................................................................................................................. 12 Categories of Service ..............................................................................................................................13 Primary Service Address .........................................................................................................................14 Billing Address ........................................................................................................................................15 Correspondence Address ........................................................................................................................16 Remittance Address ................................................................................................................................17 Other Address .........................................................................................................................................18 Group and Facility Affiliation Screen ........................................................................................................19 Upload required documents ....................................................................................................................20 Agreements.........................................................................................................................................21-22 Submission Confirmation Screen ..............................................................................................................22

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Overview

The PDMS Web Portal user guide provides step by step instructions on how to submit an electronic application to be a Medicaid provider in the District of Columbia. The PDMS dashboard displays data for each stage of the enrollment process and allows providers to start a new application or take action on previously submitted applications and re-enrollments.

Creating a User Account

The first step to submitting an online application is to create User Account in the DC Provider Data Management System (PDMS) Web Portal. Click on Create Account

Enter your Tax ID ? Enter your Social Security Number (Individual) Select the SSN Tax ID Type

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Creating a User Account ? Cont.

NOTE: For providers with a previous PCA provider number already in the PDMS system, the PCA should do the following: Contact the call center at 1-844-218-9700 and a Customer Service Representative will assist you with moving

forward in the process. Enter your NPI Click Next

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Creating a User Account ? Cont.

After successfully creating the account, a notification will appear and a confirmation email will be sent to the email address provided. Click the "Return to Home Page"

The email contains a link to the Web Portal to log in to your account using the User Name and Password you created.

Enter the User ID and Password you created Click Log In

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Provider Management Home

Select the PCA Aide application. Once you have selected your application, click Begin New Enrollment

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New Registration Box

For each required field select and enter the appropriate information Application Type: select PCA Aide

? Category: Individual/Solo, ? Provider Type ? Personal Care Assistance (PCA) Aide ? Taxonomy ? Nursing Service Related ? Name of Business Entity ? Enter the Aide's name ? Tax ID Type - SSN ? Tax ID (Prefilled) ? NPI (Required) ? Requested Effective Date (The date in the field will be auto populated with today's date.) ? Gender ? Date of Birth ? Zip Code (If 4-digit extension is unknown, use 1234. The system will validate the address and

populate the correct 4-digit extension) ? After completing all fields, click "Save."

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