Mi Via Self-Directed Waiver Consultant Enrollment

The provider enrollment application for consultant agency is available for interested providers to download. Be sure that all paperwork in the application is filled out completely and accurately.  Include all requested documentation with the application to avoid delay or denial of your application.

Please review the Mi Via Service Standards including Appendices A-G for information about the Mi Via Waiver and consultant services. Please review the other links that are provided under “Learn More” at the bottom of this page.

Consultant Guide

Effective October 1, 2018. At this time, the Consultant Guide is under construction. Please refer to the most current Mi Via Waiver Standards, Appendices and New Mexico Administrative Code (NMAC) for information about the Mi Via Waiver program and consultant services.

The Mi Via Self-Directed Waiver Consultant Guide is a guide for providing consultant services that is usable for new consultants and as a helpful reference for all consultants.

It covers a wide array of topics from agency structure, entity roles, eligibility, participant enrollment and orientation, program cycle, schedule of participant budgets, requesting additional funding, and much more.

Application Documents

The documents below will assist you with the application process.

• Mi Via Self-Directed Waiver Consultant Application Packet
• Mi Via Self-Directed Waiver Consultant Provider Agreement
• Mi Via Waiver Self-Imposed Moratorium Form

Other important documents, such as the W-9 form and the MAD-335 form can be found on the New Mexico Medicaid Portal: Provider Information website.

Service Standards

These are the most current service standards for the Mi Via Self-Directed Waiver program.

• Mi Via Self-Directed Waiver Service Standards
• Appendix A: Service Descriptions in Detail
• Appendix B: Service and Support Plan
• Appendix C: Mi Via range of Rates and Service Codes
• Appendix D: Vendor Credentialing and Information
• Appendix E: Employee Credentialing Requirements
• Toolkits
• Appendix F: Compliance Oversight and Monitoring
• Appendix G: Mi Via Training

Regulations

The following regulations pertain to the Mi Via Self-Directed Waiver program.

• NMAC 8.314.6 — Mi Via Home and Community-Based Services Waiver

Billing

Please see our Mi Via Self-Directed Waiver Billing Instructions document for more information about billing.

To receive assistance with billing, please contact Conduent (formally known as Xerox) at their 1-800-299-7304 toll-free phone number.