Clinic-based Certified Nurse Midwife Application Information
Kev tsim nyog
Hom kev cuv npe no tsuas yog rau cov kws saib xyuas neeg mob uas muaj ntawv pov thawj nkaus xwb uas muab kev pabcuam thawj zaug nkaus xwb ntawm Medi-Cal rau npe, cov chaw kho mob uas muaj ntawv tso cai, tsis muaj lwm qhov chaw tsim khoom lag luam (xws li chaw kho mob) uas lawv muab kev pabcuam thiab cov uas yuav tsum tau them nqi rau cov kev pabcuam hauv maternity muab rau cov neeg tau txais txiaj ntsig hauv tsev kho mob mob hnyav. Cov pab pawg tsis tsim nyog rau hom kev tso npe kawm no.
Pursuant to the regulatory Provider Bulletin published in June 2009, effective July 15, 2009, DHCS has established procedures for the enrollment of certified nurse midwives who are solely employed by or provide services pursuant to a contract with licensed primary care clinics, and who do not have any active Medi-Cal provider number issued to them individually to bill for clinical services to Medi-Cal beneficiaries at another location and as such, use the licensed primary care clinic as their established place of business. This type of enrollment allows the certified nurse midwife to bill for inpatient services only and not for services provided at the Licensed Primary Care Clinic. In order to determine whether or not you qualify for this type of enrollment, please read the detailed Provider Bulletin: “Requirements and Procedures for ‘Clinic-Based Certified Nurse Midwife’ Enrollment”.
Yog tias koj tsim nyog tau txais kev tso npe los ua Tus Kws Saib Xyuas Neeg Mob raws li Lub Tsev Kho Mob Certified Nurse Midwife: Clinic-Based Certified Nurse Midwives yuav tsum xa lawv daim ntawv thov kev pab los ntawm PAVE (Provider Application and Validation for Enrollment) .
Daim ntawv tso cai
Ua ntej thov rau Medi-Cal, ua ntej kos lub California Pawg Saib Xyuas Kev Noj Qab Haus Huv Lub Vev Xaib kom paub meej tias koj ua tau raws li txhua qhov kev tso cai.
Cov ntaub ntawv xav tau
Tom ntej no, sau cov ntaub ntawv xav tau hauv qab no, raws li tsim nyog, txhawm rau muab lawv tso rau hauv PAVE thaum koj ua tiav koj daim ntawv thov PAVE. Thov xyuas kom meej tias cov ntaub ntawv uas tau muab tso tawm yog pom tseeb.
- Daim Ntawv Tso Cai Saib Xyuas Neeg Mob hauv California tam sim no thiab
Daim Ntawv Pov Thawj Saib Xyuas Neeg Mob Uas Pab Yug Me Nyuam Tam Sim No. Thov muab koj daim ntawv pov thawj rau npe DEA thiab/lossis tus lej rau tus kws saib xyuas neeg mob uas yug menyuam, yog tias muaj. - Daim Ntawv Tso Cai Tsav Tsheb lossis daim npav qhia tawm hauv lub xeev (tso tawm hauv 50 Tebchaws Meskas lossis Cheeb Tsam ntawm Columbia) ntawm tus neeg thov uas kos npe rau daim ntawv thov. Daim ntawv kos npe yuav tsum yog tus kws saib xyuas mob midwife tau lees paub.
- Kev txheeb xyuas tus lej cim tus tswv haujlwm hauv tsoomfwv (FEIN) ntawm tus neeg thov tus kws pab yug menyuam,
tsuas yog tias tsis siv tus lej kev ruaj ntseg hauv zej zog, los ntawm kev xa daim ntawv Internal Revenue Service (IRS) tsim tam sim no. Cov ntaub ntawv uas siv tau tsuas yog muaj xws li Tsab Ntawv 147-C uas IRS tsim, Daim Ntawv 941 uas IRS tsim (Daim Ntawv Se Rov Qab Los Ntawm Tus Tswv Haujlwm Lub Peb Hlis), Daim Ntawv 8109-C (Daim Coupon Tso Nyiaj) uas IRS tsim, lossis Daim Ntawv SS-4 uas IRS tsim (tsuas yog Daim Ntawv Ceeb Toom Txog Kev Muab FEIN Ua Haujlwm). Lus Cim: Lub npe raug cai ntawm tus neeg thov lossis tus neeg muab kev pabcuam hauv daim ntawv thov yuav tsum phim lub npe ntawm daim ntawv IRS tsim; thiab tus neeg thov/tus neeg muab kev pabcuam yuav tsum yog tus tswv lossis tus tub ceev xwm ntawm lub koom haum uas teev nyob rau hauv daim ntawv IRS. Yog xav paub ntxiv, thov mus saib
IRS los yog hu rau lawv ntawm (800) 829-4933. - Licensed Primary Care Clinic Cover Letter from each Medi-Cal-enrolled clinic at which you provide services. The letter should include the required information as described on pages three and five of the provider bulletin titled, “Requirements and Procedures for ‘Clinic-Based Certified Nurse Midwife’ Enrollment”.
- Certified Nurse Midwife Cover Letter (at least one) that includes the required information as described on pages four and five of the provider bulletin titled, “Requirements and Procedures for ‘Clinic-Based Certified Nurse Midwife’ Enrollment”.
- Certificate of Professional Liability Insurance nyob rau hauv ib tug npaum li cas ntawm tsis tsawg tshaj li $100,000 ib daim ntawv thov thiab ib tug yam tsawg kawg nkaus txhua xyoo ntawm $300,000. Kev lees paub lees paub yog daim ntawv pov thawj ntawm kev tuav pov hwm lossis daim ntawv tshaj tawm uas muab los ntawm lub tuam txhab pov hwm uas muaj lub npe ntawm lub tuam txhab pov hwm, lub npe ntawm cov ntawv pov hwm, hnub siv tau, thiab kev txwv ntawm kev pov hwm. Nco tseg: Tus kws kho mob lub npe, raws li nws tshwm sim hauv California Daim Ntawv Tso Cai Kho Mob, yuav tsum tau qhia txog kev txheeb xyuas ntawm kev pov hwm kev lav phib xaub.
- Yog tias koj yog ib lub tuam txhab koom ua ke, kev ncua sijhawm ua tiav yuav raug zam los ntawm kev muab daim ntawv theej ntawm
Cov Lus Cog Tseg ntawm Lub Koom Haum los ntawm Tus Tuav Ntaub Ntawv ntawm Lub Xeev, thiab daim ntawv teev cov npe thiab lub npe ntawm cov thawj coj thiab cov tub ceev xwm, nrog rau feem pua ntawm kev muaj thiab kev tswj hwm rau txhua tus.
- Luam ntawm koj Daim Ntawv Qhia Lub Npe Ua Lag Luam, tsuas yog siv tau.
PAUB Portal
Txuas mus rau qhov PAUB portal.