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Becoming a Provider
Contract Providers
Directly
Enrolled Providers
CAP Providers
Guilford Center Contract Providers
Contract Providers bill the Guilford Center for services they provide under the terms of their contracts with the Center. To obtain a contract with the Guilford Center, providers must successfully respond to a Request for Proposal process (RFP) for specific programs.
Billing for Medicaid services in North Carolina is in a period of transition. In the future, all Medicaid providers will need to be directly enrolled with the N.C. Division of Medical Assistance and bill the State directly for services provided. At the current time, all independently licensed professionals and all child residential providers (four beds or more) must be directly enrolled with the Division.
The Request for Proposal (RFP) Process
The RFP process begins with a Scope of Work document and a written application.
The Scope of Work document:
- Describes the expectations of the Guilford Center regarding the services to be provided and the client population to be served.
- Lists the criteria used by the evaluation committee to score the written application.
- Identifies contract requirements for incident reporting, authorization of services, billing and insurance.
- Describes the format and time frame for submitting an application.
- Describes the appeal process in the event an applicant wishes to appeal the committee’s decision
A non-partisan evaluation committee evaluates the written
applications.
This committee is made up of Guilford Center staff, members of
the Guilford Center Board and Consumer and Family Advisory Committee,
and individuals from the community who have expertise in the subject
matter of the services under consideration.
Respondents whose applications receive an average score
of 70 or higher are invited to an interview.
In most cases, the interview includes both administrative and
clinical sections. Contracts will be awarded to those applicants
who successfully complete the interview process.
Request for Proposal Process
This process is initiated on an as-needed basis. The RFP process
is typically for a program or array of services rather than a
single service. An example of a typical RFP service would be for
a program offering substance abuse services or for vocational
services for individuals with developmental disabilities.
The RFP selection is typically limited to one or two responsible bidders whose proposals are determined to be acceptable and most responsive to the requirements of the RFP. Although cost is a major consideration, the Guilford Center may choose not to award a contract to the lowest bidder, or it may choose not to award a contract at all. Costs associated with responding to an RFP are the sole responsibility of the respondent.
CAP Providers
Effective as of October 1, 2007, the policy and procedures for becoming an endorsed CAP provider have changed. The new process is featured on the North Carolina Department of Health and Human Services, Division of Mental Health/Developmental Disabilities/Substance Abuse Services Web site.
CAP/MR- DD Question and Answers
CAP/MR-DD Endorsement Grid
If you have any questions after reviewing the new endorsement policy and procedures, contact Alexis Underwood at the Guilford Center (telephone 336.641.4363 or email aunderwood@guilfordcenter.com) for additional information.
Directly Enrolled Providers Registered with the Guilford
Center
The N.C. Division of Medical Assistance (DMA) has established a program of direct enrollment in which all providers of Medicaid services are required to be directly enrolled. To enroll in the Medicaid program, providers of Enhanced Benefits must complete an endorsement process provided through the Local Management Entity (LME).
For Information about Endorsement:
Call Alexis Underwood at 336.641.4363 or email aunderwood@guilfordcenter.com.
For Information about Direct Enrollment
Call 919.855.4050 or visit the DMA website at www.dhhs.state.nc.us/dma/provenroll.htm.
DMA determines eligibility requirements for providers and recipients,
requirements for and limitations on coverage, and documentation
requirements for directly enrolled providers.
Outpatient Treatment Services
After you receive your direct enrollment letter and Medicaid provider
number from DMA, contact Linda Earnest at the Guilford Center
(telephone 336.641.6749 or e-mail learnest@guilfordcenter.com)
for an Outpatient Treatment Memorandum of Agreement (MOA) with
the Guilford Center. The purpose of the Memorandum is to establish
coordination of care responsibilities of the directly enrolled
provider and the Guilford Center in providing outpatient treatment
services to eligible Medicaid clients.
Residential Treatment Services
Medicaid does not pay for residential services for adults, so
this service is limited to certain eligible Medicaid recipients
age 21 or younger. You are required to be directly enrolled with
DMA if your group home has four or more beds.
After you receive your direct enrollment letter and Medicaid provider number from DMA, contact Alexis Underwood at the Guilford Center (telephone 336.641.4363 or email aunderwood@guilfordcenter.com) for additional information.
Insurance Requirements
To get an executed Memorandum of Agreement with the Guilford Center,
directly enrolled providers must obtain and maintain the following
policy or policies of insurance covering their operations:
| Coverage | Minimum Limits |
| Comprehensive General Liability | $1,000,000/$3,000,000 |
| Professional Liability, if applicable | $1,000,000 |
| Comprehensive Automobile Liability covering owned, non-owned, and hired, if transporting clients | Combined single limit of at least $1,000,000 |
The insurance company(ies) should have a Best Rating of a least B+, Class VII and be licensed in North Carolina. In addition, the provider may be required to obtain other insurance as the Guilford Center shall request from time to time.
Any provider who has more than three (3) employees must carry worker's compensation insurance in the amount of $500,000/$500,000/$100,000.