Cov ntaub ntawv thov Tus Kws Saib Xyuas Neeg Mob
Cov Tsev Kho Mob Midwives yuav tsum xa lawv tus kheej thiab/lossis cov ntawv thov pab pawg los ntawm PAVE (Kev Pabcuam Kev Pabcuam thiab Kev Pabcuam rau Kev Sau Npe). Yog tias koj tab tom xa ib daim ntawv thov pab pawg, thov xyuas kom koj xa tsawg kawg ob daim ntawv thov kev ua haujlwm hauv PAVE txhawm rau tsim koj pab pawg.
Yog tias koj tab tom tso npe ua ib tus neeg 'sawv ib leeg' tus kws kho mob lossis ua ib tug 'tus kws pab yug menyuam uas tau ntawv pov thawj hauv tsev kho mob'
, koj yuav tsum xa koj daim ntawv thov ntawm PAVE.
Raws li Txoj Cai Welfare and Institutions (W&I) Tshooj 14043.75(b), cov kev cai rau cov kws saib xyuas neeg mob uas tau ntawv pov thawj uas thov rau kev rau npe hauv qhov kev pab cuam Medi-Cal tau hloov kho tshiab lawm. Yog xav paub ntxiv, thov saib daim ntawv tshaj tawm ntawm cov chaw muab kev cai lij choj uas muaj npe hu ua, "Cov Kev Cai thiab Cov Txheej Txheem rau Kev Sau Npe Ua Lag Luam Tshiab rau Cov Kws Pab Yug Me Nyuam uas Muaj Ntawv Tso Cai thiab Cov Kws Pab Yug Me Nyuam uas Muaj Ntawv Pov Thawj " thiab cov ntaub ntawv Cov Lus Nug thiab Cov Lus Teb los ntawm Lub Rooj Sib Tham Txog Cov Neeg Muaj Feem Xyuam uas tau muaj nyob rau lub Yim Hli 1, 2024. Tsis tas li ntawd xwb, thov saib cov lus qhia txog yuav ua li cas xa daim ntawv thov rau PAVE raws li koj hom koom haum:
- Nurse Midwife Rendering Provider Application
- Daim Ntawv Thov Tus Kws Kho Mob Tus Kws Kho Mob Tus Kheej Tus Kheej
- Nurse Midwife Group Daim Ntawv Thov Kev Pab Them Nqi
Daim ntawv tso cai
Ua ntej thov rau Medi-Cal, ua ntej kos nrog California Pawg Neeg Saib Xyuas Kev Noj Qab Haus Huv uas tau sau npe kom paub tseeb tias koj ua tau raws li tag nrho cov cai ntawm daim ntawv 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.
1. California Registered Nurse License thiab California Nurse-Midwife Certificate; California Nurse-Midwife Furnishing Certificate yog muab tshuaj thiab khoom siv raws li B&P Code Tshooj 2746.51 thiab DEA Kev Sau Npe yog tias koj muab cov tshuaj tswj hwm.
2. 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) rau tus neeg thov.
3. Certificate of Professional Liability Insurance nyob rau hauv tus nqi ntawm tsis tsawg tshaj li $100,000 ib daim ntawv thov thiab ib tug tsawg kawg nkaus txhua xyoo tag nrho 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 tuav 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 pom nyob rau hauv California Daim Ntawv Tso Cai Saib Xyuas Neeg Mob thiab Daim Ntawv Pov Thawj Tus Kws Saib Xyuas Neeg Mob, yuav tsum tau qhia txog kev pov hwm kev pov hwm kev lav phib xaub.
4. For ‘individual stand alone enrollment‘: Yog tias tsis siv tus lej social security, kev txheeb xyuas tus lej Federal Employer Identification Number (FEIN), los ntawm kev xa daim ntawv Internal Revenue Service (IRS) uas tsim tawm 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), 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 xwb). 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 lossis hu rau lawv ntawm (800) 829-4933.
5. Rau 'kev sau npe ib leeg xwb': Certificate of Commercial Liability Insurance (kev lag luam, kev lag luam, lossis kev lav phib xaub, lossis kev tuav pov hwm hauv chaw ua haujlwm) hauv tus nqi tsis pub tsawg dua $ 100,000 rau ib daim ntawv thov thiab qhov tsawg kawg ib xyoos ib zaug ntawm $ 300,000. Kev lees paub lees paub yog pov thawj ntawm kev tuav pov hwm tus kheej, lossis 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 thiab chaw nyob ua lag luam ntawm cov ntawv pov hwm, hnub siv tau, thiab kev txwv ntawm kev pov hwm. Nco tseg: Lub npe thiab chaw nyob ua lag luam, suav nrog tus lej suite yog tias tsim nyog, ntawm tus neeg thov lossis tus neeg muab kev pabcuam hauv daim ntawv thov yuav tsum ua raws nraim li daim ntawv pov hwm lub npe thiab chaw nyob ntawm daim ntawv pov thawj ntawm kev tuav pov hwm lossis daim ntawv tshaj tawm.
6. Rau 'kev sau npe ib leeg xwb': Daim Ntawv Pov Thawj ntawm Kev Pov Hwm Kev Raug Mob ntawm Cov Neeg Ua Haujlwm yog qhov yuav tsum tau ua los ntawm txoj cai lij choj California, yog tias koj lub lag luam muaj ib lossis ntau tus neeg ua haujlwm. Daim ntawv pov thawj lees txais tau yog pov thawj tias koj muaj kev pov hwm tus kheej, lossis daim ntawv pov thawj pov hwm lossis daim ntawv tshaj tawm uas lub tuam txhab pov hwm muab uas muaj lub npe ntawm lub tuam txhab pov hwm, lub npe thiab chaw nyob ua lag luam ntawm tus neeg pov hwm, thiab hnub siv tau. Yog tias tsis tas yuav muaj kev pov hwm rau cov neeg ua haujlwm raug mob, yuav tsum muaj lus piav qhia. Lus Cim: Lub npe thiab chaw nyob ua lag luam ntawm tus neeg thov lossis tus neeg muab kev pab yuav tsum phim lub npe thiab chaw nyob ntawm tus neeg pov hwm uas nyob rau ntawm daim ntawv pov hwm.
7. For ‘individual stand alone enrollment’: Signed Lease Agreement, if business premises are not owned by the applicant or provider. Note: The name and business address of the applicant or provider must exactly match the lessee’s name and address on the lease agreement.
8. Rau 'kev sau npe ib leeg': Daim Ntawv Tso Cai Lag Luam Hauv Zos, Daim Ntawv Pov Thawj Se, thiab Daim Ntawv Tso Cai rau txhua lub nroog thiab/lossis lub nroog uas muaj kev ua lag luam. Lus Cim: Lub npe thiab chaw nyob ua lag luam ntawm tus neeg thov lossis tus neeg muab kev pab uas nyob rau hauv daim ntawv thov yuav tsum phim lub npe ua lag luam thiab chaw nyob ua lag luam uas nyob rau hauv txhua daim ntawv tso cai thiab daim ntawv tso cai hauv zos. Yog tias tsis tas yuav muaj daim ntawv tso cai ua lag luam, thov xa ib daim ntawv sau los ntawm koj lub nroog/lub nroog hauv zos uas qhia tias koj lub lag luam tsis tas yuav muaj daim ntawv tso cai lossis daim ntawv tso cai. Yog xav paub ntxiv, thov hu rau koj lub chaw ua daim ntawv tso cai ua lag luam hauv nroog thiab/lossis mus saib California State Association of Counties thiab nyem rau ntawm qhov txuas "California's Counties", thiab xaiv "Counties Web Sites."
9. For ‘individual stand alone enrollment’: Recorded/stamped Fictitious Business Name Statement (FBNS), issued by the county where the principal place of business is located, if using a fictitious business name AND the business name is different from the legal name on your application. For example, in the case of a corporation, any name other than the corporation name on record with the Secretary of State requires a FBNS. Note: The business name and business address of the applicant or provider on the application, all local business licenses/permits, and the FBNS must exactly match. To determine the applicable county agency where fictitious business names are filed, please visit the California State Association of Counties and click on the “California’s Counties” link, and select “County Web Sites.”
10. Rau cov neeg sau npe ib leeg xwb t’: If your business is a corporation, processing delays may be avoided by attaching a copy of the filed Articles of Incorporation from the Secretary of State, and a list of directors’ and officers’ names and titles, with percent of ownership and control interest for each. To verify or change the name and/or status of your corporation or for further information, please visit the Secretary of State California Business Portal and click on the “California Business Search” link or other appropriate link.
11. For ‘individual stand alone enrollment’: If your business is a partnership, a fully executed Partnership Agreement. Processing delays may be avoided by indicating whether the entity is a General Partnership or Limited Partnership and also submitting the following:
a) Rau General Partnership, ib daim ntawv teev npe ntawm txhua tus neeg koom tes nrog feem pua ntawm cov tswv cuab lossis tswj cov paj laum rau txhua tus; los yog
b) Rau Kev Koom Tes Ua Lag Luam Txwv, cov ntaub ntawv txheeb xyuas tus khub General, thiab cov npe ntawm txhua tus neeg koom tes nrog feem pua ntawm cov tswv cuab lossis tswj kev txaus siab rau txhua tus.
To verify or change the name and/or status of your partnership or for further information, please visit the Secretary of State California Business Portal and click on the “California Business Search” link or other appropriate link.
12. Rau 'kev sau npe ib leeg xwb': Kev lav ris ntawm tus neeg ua tiav nrog Daim Ntawv Cog Lus Ua Ke thiab Ntau Tus Neeg Lub Luag Haujlwm (DHCS 6217), yog tias siv tau.