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Access to Services: 877-470-7130  Customer Service: 877-470-3195
Crisis Help Line: 877-470-4668  TTY/TDD: dial 711

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Access to Services: 877-470-7130
Customer Service: 877-470-3195
Crisis Help Line: 877-470-4668 – TTY/TDD: dial 711

Access to Services: 877-470-7130
Customer Service: 877-470-3195
Crisis Help Line: 877-470-4668 – TTY/TDD: dial 711

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      • FY2020
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    • PREMIUM PAY
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  • RECIPIENT RIGHTS
  • RESOURCES
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    • COMMUNITY
    • PRESS RELEASES
Menu
  • HOME
  • ABOUT US
    • MISSION, VISION AND VALUES
    • ANNUAL REPORT
    • BOARD
    • LOCATIONS
  • SERVICES
    • ACCESSING SERVICES
    • GUIDE TO SERVICES
    • FEE POLICY
    • PRIVACY NOTICE
    • SERVICES & SUPPORTS
    • PROVIDER DIRECTORY
  • CAREERS
  • PROVIDERS
    • TRAINING
    • BECOME A PROVIDER
    • PROVIDER MANUAL & GENERAL INSTRUCTIONS
    • CLAIMS
    • MEETINGS AND PUBLICATIONS
      • PROVIDER QUARTERLY BULLETINS
      • FY2022
      • FY2021
      • FY2020
      • FY2019
      • FY2018
    • PREMIUM PAY
    • PROVIDER COVID GUIDELINES
  • RECIPIENT RIGHTS
  • RESOURCES
  • NEWS
    • COMMUNITY
    • PRESS RELEASES

NORTH COUNTRY CMH CONTRACT PROVIDER MANUAL

Consumer Direct Care Network Michigan Fraud Prevention Video
Day Program Services
Licensed Residential Home (AFC, CFC)
Personal Residential Home (PRH)
Professional or Support Services

PROVIDER TIME STUDY INSTRUCTIONS

Provider Instructions for Time Studies
Time Study PDF Template
Time Study Example 1
Time Study Example 2
Time Study Calculating Template

PROVIDER FORMS

01 – Provider Application 
02A – Provider Entity Disclosure of Ownership
02B – Provider’s Subcontractor Disclosure of Ownership
03 – False Claims Attestation
04 – Federal Form W9
05 –  Contracted Entity Management/Control Background Check Release Form
06 – Contracted Provider Insurance Requirements
07 – Workman’s Compensation Exclusion Statement
08 – Provider training Material & Manual Attestation
09 – Provider EFT Vendor Authorization for Direct Deposit
10 – Provider NorthStar User Verification Form

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Access to Services:
877-470-7130

Customer Service:
877-470-3195

Crisis Help Line:
877-470-4668
TTY/TDD: dial 711

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