Therapist Contractor File Requirements

  1. IRS W-9, click here: www.irs.gov/pub/irs-pdf/fw9.pdf (We also allow W4: https://www.irs.gov/pub/irs-pdf/fw4.pdf)
  2. Social Security Card (Scan at 200% & lighten image)
  3. Driver License (Scan at 200% & lighten image)
  4. Auto Insurance
  5. Professional License
  6. Liability Insurance, click here for recommendation: www.hpso.com
  7. I-9 download here
  8. MTS application: This file includes the application for employment, background check authorization, I-9 form, W-9 form, The Central Registry of Offenders Against Individuals with Developmental Disabilities Employee/Volunteer Consent for Employers to Check Registry, CARI Consent form, Personal Vehicle Use Policy, Employee Authorization for MVR Review, Personal Vehicle Use Agreement, Fingerprint form, and the Physical Form – all provided below:
  1. NPI Application instructions, download here
  1. CMS 855I, download here 
  1. CMS 855R download here