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Individual pca 2026
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- Click ‘Get Form’ to open the Individual PCA Data Sheet in the editor.
- Begin by filling out the Agency Information section. Enter the Date of Request, PCA Agency Name, BCBSMN ID #, Street, City, and Zip code. Ensure all details are accurate for smooth processing.
- In the PCA Information section, specify whether you are adding or terminating a PCA service provider. Fill in the Effective Date and provide the Last Name, First Name, Mid Initial, Gender, Date of Birth, Title, and NPI/UMPI # for each PCA.
- If applicable, indicate if the PCA holds a Supervisory position. Repeat this process for additional PCA providers as needed.
- Complete the Person Completing Form section with your name, E-Mail Address, Signature, and Phone #. Review all entries for accuracy before submission.
- Once completed, submit by Email or Fax using the provided contact information.
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minnesota comments
Accordingly, a person with disabilities requiring a Personal Care Assistant (PCA) to accomplish activities of daily living are permitted to have a PCA accompanyRead more
Minnesota Health Care Programs requires all individual PCAs to take the Individual Personal Care Assistant (PCA) training and pass a one-time online test.