Children’s Long-Term Support: Provider Registration

Would you like to be a Children’s Long-Term Support (CLTS) provider? Take the first step. Register with us.

How to register

Follow these steps to register. You’ll need to register again every four years.

Note: Do not register if you are employed by an agency. Do not register here if you turn in time sheets to a fiscal agent. Ask your employer for more information. Or contact your county Human Service Department.

1. Get your information together. Use the business name you use to report to the IRS.

Are you a county waiver agency? Do you provide medical services? You’ll need your national provider identifier (NPI) as well.

2. Fill out one of these forms:
   • If you have staff to deliver your service, you are a provider agency. You should register at: CLTS Provider Agency Registration, F-02617.
   • If you do not have staff, you are a sole proprietor. Register at: CLTS Sole Proprietor Registration, F-02672.
   • If you deliver financial management services and issue payments to self-directed workers, you are a fiscal agent/fiscal intermediary. You should register at: CLTS Fiscal Agent and Fiscal Intermediary Registration, F-02534.

Do you deliver more than one type of service? You can register as two provider types if:

• You are a sole proprietor and fiscal agent/fiscal intermediary provider.
• You are a provider agency and fiscal agent/fiscal intermediary provider.

Please note: you cannot register to be both a sole proprietor and a provider agency.

If you aren’t sure what type of provider you are, you can find out. Call Provider Registration and Directory Assistance at 833-940-1576.

After you’ve registered, you’ll get an email to confirm. Save that email. You will need it to make changes later on. You’ll also need it to update your registration.

3. After you register, the Wisconsin Department of Health Services (DHS) will share your information with the county waiver agency in the county where you hope to deliver services.
4. Get in touch the county waiver agency in the county where you hope to deliver services. They will handle the rest of the process. That may include:

• Authorizing services
• Background checks
• Making contracts

Note: You are an initially approved provider as soon as you’ve filled out the CLTS Provider Registry. The county waiver agency must fully approve your status before you are authorized to deliver services.

Questions? Call Provider Registration and Directory Assistance at 833-940-1576.

How to update your registration

Are you already a CLTS provider? Do not use the forms in the process above. Call Provider Registration and Directory Assistance at 833-940-1576. Ask for a new registration link to be emailed to you. Use the new link to:

• Sign up for new and reorganized services.
• Update your business information.

Helpful contacts

1. Your local county waiver agency. They can:
   • Help direct care workers get set up with a fiscal agent or other agency.
   • Help you find more information about being a provider in a specific county.
   • Approve you to provide services in a specific county.
2. Provider Registration and Directory Assistance. Call 833-940-1576. They can:
   • Answer your questions about registering.
   • Help you use the provider directory.

New provider resources

Check out the CLTS resources for providers web page. It has important information, including:

• Claims processing
• Guides and resources
• Provider bulletins
• Program policy
• The provider directory
• Rates
• Registration 

CLTS claims payment information

DHS contracts with a third-party administrator claims processing vendor. The vendor is Wisconsin Physicians Service.

As a provider, you will turn your claims in to Wisconsin Physicians Service for payment.

DHS has payment rates that are the same across the state for most CLTS services. You are paid based on these rates. You can find out more at the CLTS Program Service Rates web page.

Learn more about the benefits of being a CLTS provider

Helpful tips

• Need more help with registration? Read CLTS Provider Registration Instructions Tip Sheet, P-02564 (PDF).
• Get the news you need. Sign up for the CLTS provider email list.
• Find more about the CLTS program:
  • Provider Services at a Glance, P-03181 (PDF) .
  • Medicaid Home and Community-Based Services (HCBS) Waiver Manual for the CLTS Waiver Program, P-02256 (PDF).