Section 5: Managing Your CLTS Program Enrollment

Keeping your CLTS provider enrollment current

As a provider, you must keep your information up to date by updating your enrollment in the CLTS Provider Registry when there is a change in or update to your:

• Billing information.
• Directory location(s).
• Primary or third-party administrator (TPA) contact(s).
• W9 name.
• Social Security number (SSN).
• National provider identifier (NPI).
• Certification(s) and license(s).
• Other required documents as defined by the applicable service description(s) in Medicaid Home and Community-Based Services Waiver Manual for the CLTS Waiver Program, P-02256 (PDF), Chapter 4.6. You have 24/7 access to update information in the CLTS Provider Registry. DHS will review provider information changes submitted through the submit changes or update registration process and complete upon review either approving or sending out a pending email for additional information.

All providers must re-enroll and submit a new completed CLTS Medicaid Provider Agreement every three years. DHS will send multiple reminders via email to remind you to re-enroll via the online registry system. Always make sure your email address on file is up to date so you don’t miss these. Providers have 30 days after their renewal date to update their enrollment. CLTS providers should start by navigating to the CLTS Provider Registry.

How to manage documents within the registry

The CLTS Provider Registry allows you to upload documents and manage and make changes to your CLTS Program enrollment.

Notifications about registrations

You may receive email notifications about your registrations if:

• A registration is approved (or denied).
• A pending registration requires additional information. The certification or license you used as the basis for a qualification is coming due.
• A registration is coming up for renewal.
• A new or existing registration has been inactivated.

Editing approved registrations

The following edits do not require DHS review:

• Updating service area(s)
• Removing services
• Updating billing contact information (name, title, phone, mobile, fax, email)
• Adding or updating directory locations
• Adding or removing files

If no review is required, you can directly edit fields in the registration.

For detailed instructions on viewing, updating, or renewing registrations, visit Provider Users: View, Update, and Renew a Registration, P-03312b (PDF).

Managing individual locations and services

The addresses you list for your enrollment are important. Provider addresses include:

• Directory or practice location(s)—the location(s) provided in the CLTS Program Provider Directory. Each unique service location needs a separate Medicaid identification number (MA ID).
• PA address—where ForwardHealth mails PA information.
• Mailing address—where ForwardHealth mails general information.
• Financial address—for paper checks.
• 1099 mailing sddress—for the 1099 form.

Providers can also add a new service or expand their service area, but there are a few things to remember:

• Select all current services and service areas. When adding a new service or service area, make sure to select all your current services and service areas too. Make sure that the service or service area is added to the main page before it can be added to the directory location section. Forgetting this step will remove current selections from your registration and the public directory or give you an error message.
• Main registration details and each service location need to be updated. The updated selections on your main registration do not transfer to each service location on your registration. If you have multiple service locations (addresses), you will need to add the new service or service area to each service location where you provide the service.
• Review the full registration page. For each service location, the system will ask, “Do you want to delete this location?” You’ll find this in the lower-left side of each location on file. Remember to answer before you save and continue.
• The updates won’t go live right away. DHS approves service updates before they are reflected on your registration or on the public directory. You cannot deliver a service to a CLTS Program participant until it is approved.
• You will have a unique MA ID number for each location. If you have multiple locations, each one will have a unique Medicaid identification number (MA ID) to determine the qualifications and requirements for the services offered there.

Adding agency services to your CLTS Program provider enrollment:

• FMS providers who provide other services must create a duplicate location for their enrollment. So you will have one for non-FMS services and one specifically for FMS billing purposes.
• Rates are associated with the Medicaid identification number (MA ID). Individual rates are applied to all claims submitted under an MA ID associated with the FMS directory location or the MA ID associated with the non-FMS location.
• You must submit claims to ForwardHealth with the correct MA ID to receive the appropriate rates.

Changing enrollment from a sole proprietor to agency provider

Any time a change in ownership occurs and a new tax ID is issued, you must begin your new CLTS enrollment as an agency provider with an end date for your enrollment as a sole proprietor.

National provider identifier (NPI)

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 requires the adoption of a unique standard identifier for health care providers. The NPI Final Rule (PDF) issued January 23, 2004, adopted the NPI as this standard. The NPI is the 10-digit standard unique health identifier for health care providers.

Provider revalidation

The Wisconsin Department of Health Services requires providers to re-register every three years. You can find your renewal due date and begin the registration by logging into the CLTS Provider Registry. You cannot renew your registration more than 60 days prior to your renewal date. Before starting your online renewal:

1. Gather the business information you will need: documents that include your business name as reported to the Internal Revenue Service (W9 form), Your Tax ID number, and either your federal Employment Identification Number or your Social Security number. If required, you will also need your licensure or certification credentials, training and work experience information, and National Provider Identifier (NPI) if you are a provider delivering medical services or equipment.
2. During the registration, you will be redirected to an external website to complete and upload a CLTS Program Provider Agreement and Acknowledgement of Terms of Participation for Service.

Sixty days before your renewal date, you will receive an email notification. After you log into the CLTS Provider Registry, you will find your information pre-populated in the registration. Select Renew to start.

You can update the fields as needed. This includes adding, editing, or removing services, qualifications, and directory locations.

You will receive email reminders to log in and renew at 45, 15, and 5 days before your renewal deadline. If you have specific questions on how to view, update, or renew registrations in the CLTS Provider Registry, please contact the CLTS Provider Contact Center at 833-940-1576.

Registration deactivation policy

If you receive a deactivation notice, you will be notified by email and by regular mail with 10 days and invited to reply. You may need to provide documentation to avoid deactivation. If a renewal is inactivated due to non-response in a timely manner and you wish to have it reopened, you have 30 days from the date of inactivation to contact DHS at cltsprovider@dhs.wisconsin.gov. If you complete the renewal within 72 business hours, you should not experience billing interruption. If you fail to complete the renewal within 72 business hours, your status will revert to deactivated. You will then need to start over as a new enrollee, and you should expect a gap in billing.

CLTS Provider Contact Center

If you have questions about the enrollment process or need help navigating the registry, contact the CLTS Provider Contact Center at 833-940-1576 or dhscltsprovider@dhs.wisconsin.gov.