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What Happens Next – Watch This Quick Video
Process to get on Care!
Patient Journey
Community HealthChoices (CHC) Waiver Enrollment Process
Referral to Maximus
You will first be connected to Maximus, the state’s Independent Enrollment Broker (IEB). They will help guide you through the enrollment process.
Forms & Initial Steps
- A Community Referral Form will be completed to begin the process.
- Your physician must also complete and submit a Physician Certification Form to Maximus.
Initial Assessment
Maximus will schedule an intake meeting with you to assess your needs and abilities. This helps determine which program(s) you may qualify for.
Area Agency on Aging (AAA) Assessment
Maximus will refer you to your local Area Agency on Aging (AAA).
- AAA will contact you for a second assessment to determine if your needs meet the waiver requirements.
- The results of this assessment are sent back to Maximus.
Eligibility Review
Based on:
- the Physician Certification Form
- and the AAA’s assessment, Maximus will decide if you qualify for waiver services.
- If approved, your application is sent to the County Assistance Office (CAO).
Financial Eligibility Determination
- CAO reviews your application to determine if you are financially eligible for the program.
- If approved, CAO notifies your Managed Care Organization (MCO).
Service Authorization
- Your MCO evaluates your needs and determines how many hours of care you qualify for.
- Once finalized, an authorization is submitted to begin services.
Caregiver Enrollment Journey
Document Collection
The caregiver provides demographic information and required employment documentation to begin the onboarding process.
Training Completion
The caregiver must complete all required Pennsylvania state training modules to ensure they are prepared to deliver quality care.
Background & Reference Checks
The caregiver will undergo and must pass all necessary background checks and reference verifications as part of the compliance process.