New Provider and Onboarding Resources
Information and resources for new providers that wish to provide services to individuals with intellectual and/or developmental disabilities in the State of New Hampshire.
To become a provider agency in NH, you need to initially work on obtaining the ability to bill by becoming a Medicaid-Enrolled Provider. In addition to that, you need to register your business name with the NH Secretary of State. An application for licensing and certification of the new facility is also required, please visit Health Administration Facilities to begin the certification process.
Please review the He-M Administrative rules pertinent to the type of services you plan to offer under Supplemental Information.
Once that is done, you would then work with area agencies to advertise your desire to provide supports for individuals.
Becoming a Medicaid-Enrolled Provider in New Hampshire
Under federal regulations from the Centers for Medicare and Medicaid Services (CMS), providers must have the option to bill for services directly through the State’s Medicaid Management Information System (MMIS) or use a third-party biller.
All providers providing services, including all Area Agencies, for individuals under the Developmental Disabilities (DD) Waiver, In-Home Supports (IHS) Waiver, and/or Acquired Brain Disorder (ABD) Waiver must be a Medicaid enrolled provider, whether they intend to bill directly or not.
- Visit NH’s MMIS Health Enterprise Portal to submit an application, which also includes instructions based on what type of provider enrollment you are looking for. This is supported by Provider Relations, if you need assistance or guidance on where to obtain certain information that is required to complete the application.
- Entities interested in being a trading partner will also need to go through the direct-bill enrollment process.
After you have completed and submitted the application for provider enrollment, you may reach out for status updates at:
- Developmental Services
- Home and Community Based Services Waivers
- Health Facilities Administration
- General Court of NH Chapter He-M Rules
- Administrative Rules
- BDS Policies, General Memos, Guidance Documents, and Reports
- BDS Budget Templates
- Provider Information and Resources
- Settings Rule for the Statewide Transition Plan
- Medicaid Provider Relations
Settings Rule
To help ensure services integrated in community based settings meet the Final Settings Rule, the New Provider Self Assessment should be completed and submitted to BDS at BDS@dhhs.nh.gov. The Waiver Transition Team members will then meet to discuss and determine next steps which may include in-person Final Settings Rule Site visits. Please visit Settings Rule for the Statewide Transition Plan for additional information.
Screening Process
New Providers will need to complete a screening through the Bureau of Developmental Services (BDS). This process is outlined in He-M 504 - "Provider and Provider Agency Operations".
Each provider applicant shall participate in a department screening upon enrollment and re-enrollment to review the following:
- Mission and vision statements, as applicable;
- Training practices, such as but not limited to, requirements per specific position, purchased training platforms, and continuing education hours requirements;
- Service-specific competencies, as related to developmental services defined in chapter He-M 500;
- Three references that illustrate the provider applicant’s ability to meet their service obligations in accordance with their mission and vision statement;
- Financial indicators of fiscal integrity, including but not limited to; a. Financial statements identifying current portion of long-term debt payments (principal and interest); and b. A measure of total current assets available to cover the cost of current liabilities;
- Liability protections;
- Policies and practices regarding restraint and seclusion;
- Attestation that criminal background and appropriate registry checks were completed pursuant to He-M 504.03 (g)-(h);
- Attestation that office of inspector general checks were completed in accordance with HeM 504.03(n).
Please contact BDS at BDS@dhhs.nh.gov to complete the screening.
NH Easy Training
NH Easy User Guide - Phase One - Area Agencies only
NH Easy User Guide - Phase Two
- NH Easy: CMA and CM Assignments (YouTube)
- NH Easy: Individual Information and Assessments (YouTube)
- NH Easy: Service Authorizations (YouTube)
NH Easy User Guide - Phase Three
- NH Easy: User Management
- NH Easy: Provider Portal (YouTube)
Additional Resources
- Provider Onboarding and Operational Guidance - June 2023
- Provider Billing SOP Guidance - June 2023
- Residency Agreement FAQs (10/20/23)
- Provider Readiness FAQ - Spring 2023
- Provider Enrollment FAQ - Spring 2023
- Service Coordination Function List - Effective 7/1/2023
- BDS Specialty Services Special Session Presentation - 5/4/2023
- List of Medicaid Enrolled Trading Partners
- MMIS Claims Submission Overview Recording
- BDS Waiver Services (Specialties)
- 2022 Provider Enrollment Webinar Recording
- 2020 Provider Enrollment Webinar Recording
- Provider Enrollment Reference Presentation - Fall 2022
- Direct Bill Memo to Providers - August 2022
Registry Checks
Search the Exclusions Database | Office of Inspector General
Please refer to the below links to access the following forms:
- BEAS Registry Consent Form
- DCYF Central Registry Check (Individual & Third Party)
- Criminal Record (State Police) Check
- Motor Vehicle Record Check