CDC+ Forms and Information for Consumers, Consultants, and Employees
| Toll-free Customer Service Line |
1-866-761-7043 |
| Toll-free fax |
1-888-329-2731 |
| Program Administrator |
Liesl Ramos |
| Financial Services Administrator |
Susan Nipper |
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| Quick Links Menu |
| Announcements |
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A complete list of all announcements regarding the CDC+ Program.
Includes current and past issues of the CDC+ Connection. |
| Participants |
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A viewable and downloadable version of the Participant Notebook and
Appendix. The Appendix includes all forms that are used by participants
in the CDC+ Program. |
F/EA Enrollment forms
Consumer Packet
Employee Packet
Vendor Packet |
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These are all the forms required for the consumer (participant) and his or her employees and vendors to become enrolled with the Fiscal/Employer Agent. These documents provide authorization required by the Federal government and the state of Florida to pay your employees and vendors, withhold and pay employer and employee taxes and other required payroll withholdings, and communicate with the IRS and the Florida Department of Revenue on your behalf as it relates to your CDC+ household business. |
| Consultants |
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All forms required for Waiver Support Coordinators to become enrolled
with Medicaidto provide consultant services and to be entered into the
CDC+ Consultant Registry,which is required before a CDC+ participant
can select a consultant. |
| Online Payroll Submission |
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Links to the online payroll system. |
| Household Employer Forms |
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Forms required by the Federal government to be used by all employers
to provide to their employees and/or to have prominently displayed
in the workplace. |
News & Announcements
For the Latest CDC+ Announcements, Information, and Updates
CDC + Announcements
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Online Submissions
CDC+ Timesheet & Invoice Entry System
This is where you are to enter your CDC+ timesheets, invoices, and reimbursement requests
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Participants
| Document |
Description |
Participant Notebook
Version 3.0 (February 2009) |
The Consumer Notebook provides critical program
information for CDC+ participants and representatives. |
Participant Notebook Version 3.0
Page Updates
(Effective 12/1/2009) |
This section provides a completed Update Log and
approximately 80 pages of the Participant Notebook
that have been revised effective 12/1/2009. If you have
downloaded the Participant Notebook Version 3.0
from the Web site, please remove the referenced pages
and replace them with these pages. |
Appendix to Participant Notebook
(November 2009) |
This section provides all the forms used by participants
in the CDC+ program. Just "click" on the document you
want to review. Each appendix title contains a description
of every document listed in that appendix title. The
appendix will be updated periodically as forms are revised.
Forms published on the Web site are the most recent forms,
so please refer to this Web site often. |
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Consultants
APD Consultant Guide & Forms
Consultant Guide
The Consultant Guide is currently under revision. The recently published Consumer Notebook will henceforth be the Core document of APD's CDC+ program. APD is developing a guide for consultants, a guide for area liaisons, and a guide for central office staff. Each guide will expand on the roles of the specific staff groups as they relate to the information contained in the Consumer Notebook. When the Consultant Guide is completed, it will be distributed to all Consultants and will be posted on this site.
CDC+ Consultant Forms
These forms are for the sole use of the consultant.
| Document |
Description |
| Steps to Becoming a Consultant |
Tells you everything you need to know to become a consultant for CDC+. |
Provider Enrollment Cover Sheet
(Checklist) |
This form is the cover sheet for the package you must complete to become authorized by Medicaid to provide consultant services and to be added to the CDC+ Consultant Registry so you can be selected by CDC+ participants to be their consultant. |
| File Maintenance Form - Blank |
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| Consultant Memorandum of Agreement |
The Memorandum of Agreement is a written agreement between the APD area
office and each consultant or consultant agency. The agreement sets forth
the responsibilities of the consultant or consultant agency for the
CDC+ Program. |
| Consultant Registration Form - Solo Practitioner |
Use this registration form if you are a solo practitioner. If you work for an agency and are the only WSC with that agency who is also a consultant, you must register as a solo practitioner. When a second WSC completes consultant training and registers as a consultant, you complete a Consultant Registration Update form and change from solo to agency-affiliated. |
| Consultant Registration Form - Agency Affiliated |
Use this registration form if you work for an agency. |
| Agency Registration |
Each agency with 2 or more WSCs who are registered as CDC+ consultants must register as an agency for consultant services. |
| Consultant Registration Update Form |
Use this form to change any information on your original registration form. |
| Agency Registration Update Form |
Use this form to change any information on the original registration form |
| CDC+ Participant Review Form |
Complete this form each month to document your required monthly contacts with your CDC+ Participants or their Representatives.
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New CDC+ Participant F/EA Enrollment Forms
- CDC+ Consumer Packet
Forms required for the consumer to enroll with the Fiscal/Employer Agent
- CDC+ Employee Packet
*** Forms submitted must be in English. Spanish version is provided for reference only.
- CDC+ Vendor/Independent Contractor Packet
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Online Submission Tips
- Helpful Hints for Submitting Payroll Via the Web Stystem
We encourage using the web system for payroll submittal.
The instructions for web submittal are also included on this website.
- All hours for all service codes worked by an employee during each pay period should be entered into the same timesheet screen.
You should receive only one tracking number for each of your employees during each pay period. Completing more than one timesheet screen for an employee during a pay period creates a duplication error in the system and will delay the payment to your employee.
- Only use the provider ID number that has been assigned by the CDC+ program to your DHE employees, Agency/Vendors or Independent Contractors. Before pushing the submit button, please confirm the consumer ID number you have entered and the provider ID number you have entered are correct. Using anything other than the correctly assigned ID numbers will delay the payments to your employees, agency/vendors or independent contractors.
- Please do not complete a timesheet for any services that are provided by an Agency/Vendor or Independent Contractor. Agency/Vendors and Independent Contractors will give you an invoice for the month in which they provided services, and the invoice amount must be entered into the agency/vendor and independent contractor invoice screen, not into the employee timesheet screen.
- Service codes entered on employee timesheets should be two digits only. Please do not use any letters in the service code, such as 32R, using anything other than the correct two digits will create an error in the system and could delay the payment to your provider. Although a letter is used on an employee’s paper timesheet which designates the section the employee is budgeted, you do not use these letters when entering this information in web entry. You simply select the correct plan section for each employee from the down menu.
- Agency/Vendor or Independent Contractor invoices should be entered using service codes with two digits. If you enter more than two digits, it will create an error in the system and will delay payment to your provider.
The following service codes are the only service codes that can include more than 2 digits. These services would be provided by a licensed professional and would be submitted as an Agency/Vendor or Independent Contractor invoice.
- 06A – Behavior Therapy Assessment
- 29A – OT Assessment
- 38A – Physical Therapy Assessment
- 45A – Respiratory Therapy Assessment
- 53A – Speech Therapy Assessment
- 14A – ENV Modification Assessment
- 33A – Personal Emergency Response System Installation.
- If you have allocated a portion of your CDC+ monthly budget in your approved purchasing plan to be received as a cash payment each month, it is not necessary to submit reimbursement requests for your cash receipts. The monthly cash check will be handled automatically as it has been in the past.
- Please remember it is critical that you write down, print and retain all your submitted tracking ID numbers that are issued on the web system. Without this tracking number we are unable to be fully responsive to researching any issues with payment connected with web entry submissions.
- Reminders:
- Please be sure to select the correct time period and enter the correct day for each service in the timesheet screen. It is always good practice to read over the data you have entered and verify it is correct before you push the submit button.
- Although all timesheets, invoices and reimbursements will be submitted by web entry or by calling the CDC+ Customer Service Call Center, all paperwork must be complete in order to process payments. The paper documents representing the payroll claims you have submitted for payroll must be maintained in your CDC+ file.
- All new provider enrollment forms must be received and completed correctly prior to any payment for services.DHE employees are required to have an Employee Information Form, W4, and I9. Agency/Vendors must have a Vendor Information Form and Independent Contractors must have a Vendor Information Form, and W9. Failure to provide the necessary forms will delay the payments to your employees, agency/vendors or independent contractors.
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