Provider Registration

1. Provider Registration User Guide to Self-Registration on PPL’s Web Portal

2. Purpose • To provide services to a participant in the Participant Directed Program, a provider must be credentialedand approved for services • To begin the credentialing application process, providers must self-register using the PPL Web Portal online system

3. Steps to Credentialing Approval

4. Provider Online Application Process

5. Provider Online Application • Go to the Participant Directed Program Web Portal through the link below: • https://fms.publicpartnerships.com/PPLPortal/login.aspx?MAPDP

6. Provider Online Application You will be brought to the home page of the Public Partnerships Web Portal

7. Provider Online Application Click on the ‘New Provider Registration’ Button in the bottom left corner of the screen

8. Provider Online Application – Page 1 You will be brought to a blank provider application

9. Provider Online Application – Page 1 • To begin your registration process as a provider for the MA Participant Direct Program, you must complete all the applicable fields listed below. • An important first step is identifying your provider type. You will fall into one of three categories: • Individual Provider – Independent Contractor • Individual Provider – Employee • Agency (Not an individual)

10. Provider Online Application – Page 1 • First, you must pick your ‘Provider Type’.

11. Provider Online Application – Page 1 Enter all of your demographic information

12. Provider Online Application – Page 1 Do you have a mailing address you would prefer for information to go to? Please enter that here in the ‘mailing address’ fields

13. Provider Online Application – Page 1 • When entering your TIN, keep in mind: • Agencies – your TIN is your Federal Employer Identification Number • Individual Providers – your TIN is your social security number

14. Provider Online Application – Page 1 Indicate your service region or regions you would be willing to provide services.

15. Provider Online Application – Page 1 For the PDP, we will have a public list of providers that families and participants can use to find providers. If you would like to be on this list, please click ‘yes’.

16. Provider Online Application – Page 1 Once all information has been entering into this page, click the ‘Next’ button to move on to Page 2

17. Provider Online Application – Page 2 • You can sign up to provide as many services as are applicable. • Note! Some services fall under the ‘Professional Support’ category and others fall under the ‘Direct Support Category’. There are different credentialing requirements for these two different categories. Please choose your services carefully and make sure you have all the necessary documents required to provide the services you sign up for.

18. Provider Online Application – Page 2 You will be brought to Page 2, which involves ‘Step 2: Select Services’

19. Provider Online Application – Page 2 Notice, your provider type is populated here based on your selection on Page 1. You do not need to select this field again.

20. Provider Online Application – Page 2 Click on hyperlink for either ‘Direct Support Services’ or ‘Professional Support Services’ to select the services you would like to provide.

21. Provider Online Application – Page 2 Check off all of the services you wish to provide

22. Provider Online Application – Page 2 To understand what documentation is required to be credentialed to provide services, click on the ‘Service Group Checklist’ hyperlink to see the required documentation.

23. Provider Online Application – Page 2 A Pop Up window will appear with a list of all required documentation for the services you have indicated you wish to provide. NOTE! You must have this documentation for each service indicated.

24. Provider Online Application – Page 2 First, indicate if you have reviewed the guidelines from the DPPC. Note! This document has been provided by DDS.

25. Provider Online Application – Page 2 Check off the check box for each document you will provide.

26. Provider Online Application – Page 2 Once you have completed all fields, click ‘Save’

27. Print Application Your online application is almost complete! Your final step is to print the application and send it in to PPL. Click the ‘Print Form’ button to print your application.

28. Print Application You will be prompted with a ‘File Download’ box. Click ‘Save’. Note! You need Adobe Reader to read your PDF application.

29. Print and Save Application Save your application to your desk top, or other folder.

30. Print and Save Application Click ‘Open’ to view your application prior to printing.

31. Print and Save Application Verify all of your information is accurate then print the form using your personal printer.

32. Submit Online Application Go back to your online application and click ‘Submit’ to complete the online application.

33. Online Application Complete Thank you. Your online application has been submitted. NOTE! YOU ARE NOT FINISHED! You must send in the paper application and required documentation to PPL to complete the application process!

34. Submit the Paper Application • Send: • PPL Participant Directed Program Application Form • Any required documents listed for the service(s) (See the application page for details) Send to: Public Partnerships LLC MA Participant Directed Program 6 Admirals Way Chelsea, MA 02150

35. Completion of Application • As soon as your credentials have been approved, you will receive a notification via email. • If you have any questions, please call PPL Customer Service at 888-866-0869. • Thank you for your application!