Provider instructions 2026

1. Click 'Get Form' to open the Home and Community-Based Provider Information Form in the editor.
2. Begin by entering your personal details, including your last name, first name, and date of birth. Ensure accuracy as this information is crucial for processing.
3. Fill in your agency name and Tax ID number. If applicable, indicate whether you submit claims to Morning Star of Ohio by checking the appropriate box.
4. Provide your National Provider Identifier (NPI) and Ohio Medicaid Provider number if available. This step is essential for verification purposes.
5. Select your provider type (independent or agency) and certifying agency. Include the date of certification to complete this section.
6. Check all HCBS Waiver Services you are certified to provide. Be specific about the services listed to ensure compliance with requirements.
7. Indicate the counties where you intend to provide services for Buckeye members by checking the relevant boxes.
8. Once all fields are completed, review your entries for accuracy before submitting the form through our platform.

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