Individual Provider

Individual Provider 2017-09-06T11:16:51+00:00

Individual Provider

Advance Health Management™ is a leading Individual Provider network that employs, educates, and certifies providers to specialize in direct care specific to their patient’s needs. Our CERTIFIED Individual Providers specialize in serving people with complex health problems, dual diagnosis, or simply providing quality personal care when a minimum level of support is needed.

In accordance with the Michigan Department of Health and Human Services “MDHHS” Medicaid beneficiaries enrolled in MI CAREadult home help “AHHS” have the right to choose his or her home help provider referred to as the Individual Provider. The patient is the co-employer and may terminate the Individual Provider’s employment at any time.

A Medicaid beneficiaries may not hire an Individual Provider who is a responsible relative (spouse caring for a spouse or a parent caring for a minor child), a minor (17 or under), or be the patient’s Fiscal Intermediary (FI)

The determination of Individual Provider criteria is the responsibility of our Virtual CARE Nurse in accordance with state program policy. Our Virtual CARE Nursedetermines the Individual Provider’s ability to meet the following minimum criteria during a face-to-face interview with the patient and the Individual Provider.

A Medicaid beneficiaries may not hire an Individual Provider who is a responsible relative (spouse caring for a spouse or a parent caring for a minor child), a minor (17 or under), or be the patient’s Fiscal Intermediary (FI)

The determination of Individual Provider criteria is the responsibility of our Virtual CARE Nurse℠ in accordance with state program policy. Our Virtual CARE Nurse℠ determines the Individual Provider’s ability to meet the following minimum criteria during a face-to-face interview with the patient and the Individual Provider.

Individual Provider Minimum Requirements

AGE The Individual Provider must be at least 18 years.

ABILITY To follow instructions and home help program procedures.

              To perform the services required.

              To handle emergencies.

PHYSICAL HEALTH The provider’s health must be adequate to perform the needed services.

KNOWLEDGE The provider must be dependable and able to meet job demands.

CRIMINAL HISTORY SCREEN All Individual Providers must undergo a criminal history screen prior to delivering services.

Upon being hired by the patient to provide adult home help services “AHHS” the Individual Provider must be enrolled in the Community Health Automated Medicaid Processing System “CHAMPS” and undergo a criminal history screen. The screening must be completed and passed before a provider can be paid to provide services.   

Note: Criminal history screens for Individual Providers are conducted by the MDHHS Provider Enrollment Unit and not by staff at the local office or by the Advance Health Management.

Become a CERTIFIED Individual Provider℠

Join our Individual Provider Network and become a CERTIFIED Individual Provider℠ upon completing our Care Core Certification program at Advance Health University. You will receive FREE nationally recognized accredited training to ensure you provide the highest quality of care. Then you will be eligible for a FREE scholarship to Advance Health University for course work and specialty certifications according to your patient’s needs and your areas of interest.

Become certified in:

  • Advanced Dementia Care
  • Autism Care  
  • Developmental Disabilities
  • Diabetes Care
  • Parkinson’s Care
  • Multiple Sclerosis Care
  • Post Hospital Care and much more…

Individual Provider Reimbursement

Individual Providers are reimbursed monthly after pre-approved services are provided and verification of services are delivered.  

Adult home help services “AHHS” is funded by Medicaid and payments will not be authorized by the Michigan Department of Health and Human Services “MDHHS” if the patient’s Medicaid eligibility is inactive.

Individual Providers who receive public assistance must report all income received as an Individual Provider to their family independence specialist or eligibility specialist.

Individual Providers cannot be paid if the patient is unavailable; including but not limited to hospitalizations, nursing home or adult foster care (AFC) admissions.

The Individual Provider and/or patient is responsible for notifying their dedicated Virtual CARE Nurse℠ within 7 business days of any change; including but not limited to change in provider, discontinuation of services, hospitalizations, nursing home or adult foster care admissions.

CARE Pay℠

Advance Health Management believes our Individual Provider network made up of enrolled Medicaid beneficiaries reliable family members, trusted neighbors, existing Individual Providers, or someone newly hired, are of the utmost importance to our patients care and quality of life.

We value our caregivers and therefore designate a portion of patient care cost to our Individual Providers referred to as our CARE Pay. For those who qualify, our CARE Pay provides residual supplemental income to support caregivers financially in excess of minimum wage. Advance Health Management takes pride in the fact our Individual Providers earn up to $15.00 per hour.