Provider Network: Frequently Asked Questions (FAQs)

Read answers to frequently asked provider questions in the Choices Provider Network Handbook or click on the topics below. For more information related to Claims, visit our Claims page. It includes a VIP user guide as well as Claims FAQs.

Billing / Invoicing

How can I complete my invoice electronically?

Providers complete invoices electronically through the Vendor Information Portal. Refer to the VIP User Guide or CMHI Invoice Instructions for step-by-step directions.

Do I need to send invoices to DCS still?

No, once the youth is enrolled with Choices Cross System Care Coordination program, Choices becomes responsible for all payments for services that are pre-approved, including discretionary funds.

What is a Vendor ID?

Once a provider is enrolled into the Choices Electronic Health Record system, a Vendor ID is generated. A Vendor ID is the number used to identify you in the billing system and will be provided to you by Choices. This number is different from any DCS ID number.

How do I get the Client ID number?

You may contact your local Choices clinical team for this ID number.

Payment

How will I be paid for services?

All services must qualify as “Covered Services” in order to be paid by Choices under the Agreement.

  • First, the service must be listed on Exhibit D to your contract, indicating that you have been approved to provide that specific service at an agreed-upon rate. If you wish to provide services to a youth that have not been previously included as options within your contract, please contact Provider Relations to discuss the process for adding additional services.
  • Second, the Child and Family Team (CFT) must authorize the services as appropriate and necessary for the youth and family. Our authorization process is a collaborative one – the members of the team work with the youth and family to determine the types and frequencies of services which will be most beneficial. Because providers are typically involved as members of the CFT, they could discuss their proposed treatment, understand how it plays into the youth’s overall plan of care, and provide feedback to the CFT about the youth’s progress with those services. The Choices Care Coordinator facilitates the CFT meetings and enters authorizations for those services which are approved at each meeting.

How do I receive my payment?

Providers will receive payment by Electronic Funds Transfer (EFT) or by check through the United States Postal Service. The Direct Deposit Form will be provided to you separate from this manual.

When will I receive my payment?

The terms and conditions of payment are listed in your Master Agreement unless otherwise noted by the local Provider Relations Team.

Contracts: General Questions

What kind of contract documents do I need to sign?

Most professional providers entering the Choices network will sign a Master Provider Agreement and addenda to that contract, which vary based on the state in which services are provided.

  • The Master Provider Agreement contains most of the terms and conditions on which the parties’ relationship will be based. Choices utilizes the same Master Provider Agreement across all states, which provides clarity and consistency for providers.
  • Addendum A sets out specific requirements that are needed to provide services in a specific state. If a provider is going to provide services in more than one state, that provider would need to sign an addendum for each state. The Addendum A contains requirements taken from contracts, laws, or regulations of the state’s child welfare agency or other governmental agency that governs that contract. For instance, the Addendum includes requirements for criminal background checks, child abuse checks, and insurance coverage.
  • Exhibit B, the Service Code Description, is a list of all service codes pursuant to which Choices pays for services. Each provider selects from Exhibit B those services it is qualified and willing to provide, and Choices confirms that the provider is appropriately credentialed to provide the services selected. Once the provider and Choices have agreed upon the rates which will be charged for each service, these service codes and rates are listed in Exhibit D, the Compensation Schedule.
  • Exhibit C is a list of the reports which the provider will need to submit as services are provided. If a provider already creates a similar report within its system, Choices seeks to work with that provider to utilize its existing report structure when possible.

The contract says that if the applicable laws change, this will affect my contract, even if Choices does not give me notice. Why does the contract say this?

Choices and the providers in its network are all subject to the laws and regulations of the state and federal entities that provide funds for these services. Choices has no control over whether those entities will change the laws and regulations, and Choices is obligated to follow those changes and to implement them with its network providers if applicable to them. If Choices becomes aware of a significant change that affects its providers, it will make efforts to let those providers know of that change. However, all providers are obligated to monitor and follow the laws and regulations that apply to them. If a provider determines that it no longer wants to serve Choices clients due to a change in law or regulation, it has the right to terminate its contract with Choices by following the procedure set out in the Master Provider Agreement.

Contracts: Provider Documentation

What kind of documentation will I need to provide?

You will receive a checklist at the time of contracting which will identify the documents that Choices will need to complete your credentialing process. While the documents can vary slightly based on state requirements, they typically include the following:

  • General business information, such as a W-9, direct deposit form, and an agency information sheet which includes needed contact information.
  • Documentation of background checks for your staff, including criminal background checks, child abuse and neglect checks, and Department of Motor Vehicles checks (if transporting clients).
  • Certificates of insurance demonstrating that you have the required general liability, professional liability, and worker’s compensation insurance.
  • If you are not already contracted with the state child welfare agency, Choices will also ask for additional proof of work history, licensure and certification, educational degrees, and identity.

All these documents must be provided to Choices before you can be approved to provide services to youth as part of the Choices network.

Can I utilize background checks and fingerprints from my previous agency?

No. The results can only be used for the contractor/sub-contractor that is listed on the check. For more information regarding this please refer to the following links on the Indiana DCS website:

Background Check for Department of Child Services (DCS)

National and State Fingerprint Based Criminal History Check

Where do I apply to obtain a worker’s compensation waiver?

Visit the Indiana Department of Revenue website at this link: https://www.in.gov/dor/4473.htm

Contracts: State Requirements

Why am I required to indemnify the State?

Most of Choices’ contracts with state funding agencies require Choices to indemnify the State, and for Choices to pass those obligations on when it contracts with other entities to provide services to youth and families. Therefore, Choices includes this language in its Master Provider Agreement to comply with these state requirements.

Why is the Agreement governed by Indiana law? Why does it require that disputes be settled in Indiana?

Contracts are generally governed by state law. Therefore, a court applying one state law might interpret a contract provision differently than a court applying a different state law to interpret the same language. Because Choices uses the same basic contracts for all of its providers, it needs to be able to predict and understand how those contracts will be interpreted, regardless of the state in which a provider is located. Thus, Choices chose to have its contract governed by the law of one state – Indiana.

The fact that a court will use Indiana law to interpret the contract does not mean that the provider will be subject to Indiana’s requirements for providers. The provider would be subject to the requirements applicable to its operations in the state in which it practices, and the requirements set forth in the contract and addenda. Rather, the designation of Indiana law means that if a dispute arose between Choices and a provider, the person resolving that dispute would look to Indiana statutes and court decisions to see how similar contractual provisions had been interpreted in the past.

For similar reasons, Choices also requires that any disputes be settled in Marion County, Indiana, where Choices’ headquarters are located. Because Choices maintains agreements with providers across multiple states, it would be a huge financial and administrative burden for Choices to travel to those other sites to address any legal dispute which arises. Therefore, Choices’ Master Provider Agreement requires any disputes to be addressed in one central location.

Contracts: Termination

What happens if I do not want to accept any more clients through Choices?

The Choices provider network is non-exclusive, and a provider is not required to take clients upon referral. You can turn down a referral if you choose to do so. If you determine that you no longer want to be part of the Choices network, you can terminate your Master Provider Agreement at any time by providing 30 days written notice. If you leave the network, we ask that you work with Choices to ensure continuity of care for any youth and families you are serving at that time.

Indiana Department of Child Services (DCS)

Do I use the same service codes that I used with Indiana Department of Child Services (DCS)?

No, please refer to your signed Exhibit D, which will reflect the correct codes.

Where can I find the Indiana DCS service standards?

Indiana DCS service standards are available at this link: https://www.in.gov/dcs/3878.htm.

Is Choices required to complete a Placement Agreement for youth who are placed in a group home or residential treatment facility?

Yes, the Choices Care Coordinator will include the effective date that aligns with the Choices enrollment.

Referrals

How do I receive referrals?

Each youth and family can select providers of their choosing. If you are selected by a youth and family to provide services, you will receive notification from a Care Coordinator of that selection and the type and amount of services which have initially been approved. Please advise the Care Coordinator in a timely manner if you have accepted the referral and will be providing the services. Because Choices promotes “family voice and choice” and its network is non-exclusive, Choices cannot guarantee that any provider will receive a certain type or level of referrals.

Do I need a referral for reimbursable items?

No, Choices does not require a referral for reimbursable items. However, reimbursable items must be discussed and approved with the Care Coordinator prior to purchase.

Audits

Will Choices audit my files? How does that work?

Choices works with providers on an ongoing basis to ensure that they continue to meet their contractual requirements.

  • Periodically, Choices will ask each provider for updated credentialing information to verify that all staff still meet licensing, background checks, driving, insurance, and other requirements. Depending on location and availability, a member of the Choices Provider Relations Team may meet with the provider in person to discuss the contractual requirements and view the documents. This is also an opportunity for Choices to “check in” with the provider to see how things are going overall and whether there are opportunities for the provider to expand services available to youth and families.
  • Should there be a question regarding billing or services provided, or Choices becomes aware of a concern regarding a provider’s staff member, Choices will contact the provider to discuss those concerns. Choices may ask to meet with the provider in person to review records or develop a plan to address the issue and will work to set that meeting for a time and place convenient for both parties.

Grievance Process

How do I address concerns or grievances with Choices?

Choices values its partnerships with the providers in its network and wants to know if a provider has a concern or a grievance relating to services provided to Choices’ clients or any aspect of the provider relations process. We encourage you to reach out to a Care Coordinator, a supervisor, a member of the Provider Relations team, a member of the Claims staff, or another Choices employee with the appropriate knowledge to assist in answering the provider’s questions. Any Choices employee can also assist a provider in filing a formal grievance with Choices upon request. Choices’ grievance procedure is available in the Choices Provider Handbook or on the Vendor Information Portal.

Contact Information

How do I contact my Choices team?

You may contact the main office at Choices to receive the name and number of your Care Coordinator. The main office phone number is 317-726-2121.

Who do I contact if there is an error with my billing?

Please contact Claims@ChoicesCCS.org.