How to Join
Standards to become a provider
Lakeland Care will add providers to the network when all of the following standards are met:
- The requested service is in the Family Care benefit package;
- Network capacity indicates a need for additional providers within the applicable service code category (this standard is not applicable to Community Based Residential Facilities (CBRFs), Residential Care Apartment Complexes (RCACs), community rehabilitation programs, home health agencies, day service providers, personal care providers, or nursing facilities);
- The provider agrees to be reimbursed at Lakeland Care’s contracted rate negotiated with similar providers for the same care, services, and/or supplies;
- The provider meets all applicable licensing/certification requirements as they apply to the services to be provided;
- The provider has demonstrated an ability to meet other applicable standards that are required by law or per their contract with Lakeland Care;
- The provider has positive references that demonstrate competency and quality services;
- The provider is willing to adhere to all components of Lakeland Care contract and addendums; and
- The provider is willing to submit other materials as requested by Lakeland Care to demonstrate rendering of quality service, and competency.
- Providers interested in contracting with Lakeland Care may contact the Network Relations team at Network.Relations@lakelandcareinc.com to request an application packet or may obtain copies by clicking on the links below.
- All completed application paperwork (see below) should be submitted to the Network Relations staff via mail, fax, or email (preferred). Our Network Relations staff is available to assist providers throughout the application process.
- A member of the Network Relations Team will contact the provider within 3 business days of receipt of the application paperwork.
- Upon receipt of all completed application documents, agreement of service provisions, and determination/negotiation of rates, a “Service Provider Contract” will be issued to the provider within 5 business days.
Required Application Documents
- Lakeland Care Service Provider Application (Residential or Non-Residential)
- Provider Agreement Form
- Copies of all applicable licensing/certification requirements as they apply to the service that the provider intend to provide.
- Copy of insurance policy(s) and bonding (if applicable).
- Background Check Attestation Letter
- Debarment Attestation Letter
- Training Attestation Letter
- Civil Rights Compliance Plan and/or Civil Rights Compliance Attestation Letter. For more information see: http://dhs.wisconsin.gov/civilrights/Index.htm
- Corporate Residential Facilities (does not include Skilled Nursing Facilities) must also submit the following items: