Potential ccsp provider Information
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Potential CCSP Provider InformationCommunity Care Services Program (DHS/DAS CCSP) http://www.aging.dhr.georgia.gov Select Programs, CCSP to access the Pre-Enrollment Technical Assistance Packet and view the Annual Report. Provider agency must have been in business for which application is being made a minimum of 12 consecutive months. CCSP does not guarantee client referrals. Clients have choice of providers. Pre-Enrollment Technical Assistance Training Packet In order to schedule attendance at a training, mail the Pre-Enrollment CCSP Technical Assistance Registration Form, attachments, and a check or money order of $25.00 (per person) made payable to the DAS General Training Trust Fund to: Georgia Department of Human Resources Division of Aging Services/CCSP Two Peachtree Street, NW, Suite 9.405 Atlanta, Georgia 30303-3142 Note: CCSP PSS, HDS, and ALS-G applicant agency must also submit a current, non-restricted permit issued by ORS. ERS applicant must submit a Low Voltage Contractor License issued by Secretary of State, if applicable. The CCSP Medicaid Provider Enrollment Application and the DCH Medicaid Application are distributed at the CCSP Pre-Enrollment Training. [Location DCH Medicaid application: Select Provider Information tab, go to Documents & Forms box and select ‘View Full List’. Download Provider Enrollment Application Package and, if appropriate, Disclosure of Ownership and Control Interest Statement. Complete and submit to CCSP with the CCSP Provider Enrollment Application. DO NOT submit to DCH Medicaid.] CCSP State Provider Specialists: Ruth Davis 404-657-5309 Central Savannah River Area Regional Commission Heart of GA/Altamaha River Valley Regional Commission Middle GA Regional Commission Norma Ivey 404-657-5320 Northwest GA Regional Commission Southern GA Regional Commission Southwest GA
GA Mountains Northeast GA Southern Crescent Tarrian Grant 404-657-5306 Coastal Regional Commission -OVER-
Georgia Health Partnership (DCH DMA Medicaid) http://www.ghp.georgia.gov State License or Permit Information DCH Healthcare Facility Regulation Division Questions about Personal Care Home (PCH): ALS-F, ALS-G General Information 404-657-4076 Questions about Private Home Care Providers (PHC) or Home Health: PSS, HDS General Information 404-657-5550 Long-Term Care Section 404-657-5850 Complaint Intake 800-878-6442 or 404-657-5726 and 5728 http://www.ors.dhr.georgia.gov DCH CCSP Medicaid (waiver for aged and disabled) Nancy Dubas 404-657-7211 E-mail address ndubas.dch.ga.gov
Select Provider Information tab, go to Documents & Forms box. Select View Full List: Part I Policies & Procedures for Medicaid/ Peachtree for Kids; CCSP General Manual; and, CCSP service specific manuals
Nancy Dubas 404-657-7211 E-mail address ndubas.dch.ga.gov
404-651-9976 -OVER-
August 2009 Download 11.18 Kb. Share with your friends:
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