Disclosure of Ownership and Control Interest of an Entity (DHS-5259) (PDF).PCPO or PCA Choice Provider Enrollment Application (DHS-4022) (PDF).3.Ğither register to access the Minnesota Provider Screening and Enrollment (MPSE) portal and complete your enrollment online using the MPSE portal,Ĭomplete the following and fax to Provider Eligibility and Compliance at 65 along with any required documents.1.Ěttend the training PCA Steps for Success.PCPO and PCA Choice providers must follow these steps: Any additional business sites or locations must also submit a complete application. Owners, managing employees and qualified professionals are required to attend PCA agency training before completing the enrollment process. Your initial personal care provider organization (PCPO) or personal care assistance (PCA) Choice application to enroll with Minnesota Health Care Programs (MHCP) must include all items listed in this section.
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