Steps to becoming a partnering provider in the Behavioral Health Voucher Program
The Voucher Program supports the delivery of mental health and substance use disorder services for individuals who have been impacted in some way by a weather-related disaster and/or by Covid-19. Refer to the Program Quick Facts for more information regarding providers eligible to deliver services through this program.
Step 1: Review Reference Materials
- Contact email@example.com for any questions with the provider application process.
- Quick Facts
- Rate Sheets for Services:
- Frequently Asked Questions:
- Agreement Template: This is provided as reference material only; you do not need to fill this out or complete it as you enroll. This document will serve as the base agreement between the State of South Dakota, Division of Behavioral Health, and providers providing services through the voucher program. This agreement will be populated with your information after you enroll, and sent to you via DocuSign for signature. Sample scope of work templates are available here: BHVP Agreement Attachment 1 | BHVP Addendum for MH Services | BHVP Addendum for SUD Services
- Receive ongoing information about the Voucher Program
Step 2: Compile Supporting Information
- Substitute W-9: This document is needed to set up you or your agency as a vendor. The form provided is a substitute W-9 used by the State of South Dakota, which will allow for you or your agency to receive reimbursement for services delivered. Complete the banking information section to ensure direct deposit. This document will be required to complete the enrollment form in Step 3.
- Current Certificates of Insurance: Insurance documents are referenced in the sample Agreement Template: Number 22 Insurance. These certificates of insurance will be required to become an approved provider in the Behavior Health Voucher Program. These documents can be uploaded in the enrollment form in Step 3 or will be required before contracts are active.
Step 3: Complete Provider Enrollment Form
- Provider Enrollment Form: The link will take you to an online form, which will capture the information needed to determine your eligibility as a provider. You will need to upload a completed Substitute W-9. Certificates of Insurance can be uploaded in this form, too.