Provider Certification Application
The purpose of the Community Supports (CS) provider certification process is to certify organizations that are qualified to serve as a CS provider. The Plan uses the certification process to evaluate and verify the potential CS provider’s ability to comply with the CS service requirements as outlined by Department of Health Care Services (DHCS) and the ability to submit data files and claims.
To become a CS provider, organizations should review the requirements and criteria described in the DHCS Community Supports Policy Guide. Providers must submit a Provider Interest Form (PIF) to the appropriate Plan contacts and identify the counties and CS services for which they would like to contract. PIF submission does not guarantee that the Plan will contract with the organization. PIFs will be reviewed twice a year. Health Net will invite select organizations to submit the CS Provider Certification Application with accompanying documentation to support their application and work with Health Net to establish an understanding of the CS requirements, such as services offered, populations served, staffing and capacity, and readiness to provide the services indicated. Based on review of documentation, Health Net may approve the prospective provider for contracting, create a gap closure plan to review with providers ensuring readiness for CS service provision, or decide not to move forward with a prospective provider contract for services.
The key areas of focus for the readiness and gap closure plan are driven by the required areas and CS services selected in the CS Certification Application:
Required Areas of Focus |
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Community Supports – specific section applies to select CS service
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Health Net cannot certify a CS provider who is unable to fulfill the CS requirements and/or is determined to not be able to meet CS requirements. All contracted entities are required to follow applicable state and county guidelines in addition to the Plan requirements. Therefore, the prospective CS provider will not be contracted to provide CS services under the CS benefit.