QSP Agency Enrollment
To apply as an Agency Qualified Service Provider, you will need to access the following:
Take time to watch the trainings below to get an idea on how to start with the QSP agency process.
Getting Started Agency
Duration: 33:49 minutes
This training walks you through information regarding applying as a QSP Agency and is intended to provide basic information for application requirements. It will also walk through the various forms/documents required as well as provide some direction with getting started steps.
Learn How to Complete the Following Forms
SFN 1606: Agency Request to be a Qualified
Duration: 29:20 minutes
This session walks you through how to complete the SFN 1606 application document for the agency application.
SFN 615: Medicaid Program Provider
Duration: 2:51 minutes
This session walks you through how to complete the SFN 615 application document for the agency application.
W-9: Request for Taxpayer Identification
Number & Certification
Duration: 2:32 minutes
This session walks you through how to complete the W-9 application document for the agency application.
Providers who are not self-employed, but are hired by an agency to deliver services, may utilize TrainND Northeast for training and competency evaluation as a contracted service. Training may be arranged depending upon the needs of the organization. Agencies interested in in-home care training, and SFN 750 Documentation of Competency completion for their employees, can inquire with TrainND Northeast by phone at (701) 662-1578 or 1 (800) 443-1313 ext. 21578 or by email at LRSC.trainnd@LRSC.edu.
- Adults and Aging Qualified Service Providers
- SFN 750 Competency Training
- TrainND Northeast
Provide a multitude of training and opportunities for North Dakota's workforce including in-home care providers (QSP Applying part)
- Apply for your National Provider Identifier (NPI) number
- Fraud, Waste and Abuse Training