Health Planning Council of Southwest Florida

Business Page

This page is for Early Steps of Southwest Florida's Direct Staff, Outside Providers, and Interested Providers to access forms, policies, and other business-related information, as well as, to provide assistance on the CMS and Medicaid Provider Enrollment processes.

Evaluation Calendar: March 2010

Last Updated at 11:30AM 3/5/2010

Provider Newsletter(s): March 2010 February 2010

Resources Available for Checkout at our Office:

Infant Health Mental Resources

Other Resources

Important Forms, Reports, and More...

Direct and Contracted Staff

Provider Contract (2009-10) - This form is for our Contracted Providers and is the agreement between the Health Planning Council of Southwest Florida, Inc. and the Provider.

Monthly Report (2010) - This form is used by Providers to report child and family progress to the team. It is sent to Early Steps with the monthly invoice.

Provider Invoice (2010) - This form is used by Providers to submit the monthly invoice to Early Steps.

Consultation Among Team Members - This form is used to document consultations between team members and a copy is submitted to Early Steps with the monthly invoice.

Insurance Verification Form - This form is used by Service Coordinators and/or Providers to collect insurance information for third party billing. The form is an Adobe pdf and can be edited on the computer, however the form must have original-ink signatures.

**Please note the following items open as an Adobe Portfolio:
Early Steps Contract and Attachments - This Portfolio contains twelve different items.

LHAP Medicaid Enrollment Process and Attachments - This Portfolio contains six different items, including a document with directions on how to apply to Medicaid as a Therapist and EI Professional.

ITDS Medicaid Enrollment Process and Attachments - This Portfolio contains six different items, including a document with directions on how to apply to Medicaid as an ITDS.

**As the documents come available, they will be posted and updated on this page.

Interested in becoming an Early Steps Provider?

Complete the following steps to breeze through the process.

1. If you do not have an National Provider Identifier (NPI) Number go

to https://nppes.cms.hhs.gov/NPPES/Welcome.do to apply for one.

2. Go to https://www.cmskidsproviders.com/eis/ and select Apply at the

bottom of the web page.

3. Enter your First & Last Name and then create a personal Password (at least 6
characters) using at least one of each of the following: Upper Case Letter,

Lower Case Letter, Number, and Special Character

**Document your Password**

4. When your information is accepted you will move onto the First Page of the

CMS Application and a window will pop-up noting your Username.

**Document your Username**

5. Enter all the required information (*) in each section and Select Save &

Continue to move on.

6. Once your application has been completed, submitted, and confirmed you

will receive an email from the State Office with your Provider Checklist

attached.

7. Contact us at (239) 433-6700 to continue the process and for

assistance with submitting your additional documents to the State.

For more information visit: http://www.cms-kids.com/providers/index.html.

8961 Daniels Center Drive, STE 401 | Fort Myers, FL 33912 | Phone: 239.433.6700 | Fax: 239.433.6703