WORK – UnitedHealthcare

Referral & Enrollment Process

2678 Form Instructions Abuse Registry Form Instructions NEW Acceptance Of Responsibility For Employment NEW Agency Directing Employer Enrollment Packet NEW Agency Fiscal Agent Form Instructions Agency Independent Contractor Direct Deposit Information Agency Vendor Invoice NEW Agency/Vendor/IC Enrollment Packet NEW Application For Tax Exemptions NEW Approving Service Authorizations Carryover Authorizations FAQ Carryover Authorizations Instructions Carryover FAQ NEW Completed Employer Packet (EXAMPLE) Completed Provider Enrollment Packet (EXAMPLE) Cost To Employer Chart Criminal Background Check Application NEW Criminal Background Consent NEW DO10 Instructions Direct Deposit Information NEW Employer Checklist NEW Employer FAQ Enrollment Flowchart Fiscal Agent Instructions Form W-9 Guide To Tax Exemptions How To Read Your Budget Summary NEW I-9 Completion Checklist IRS Form W-4 IRS Form W-4 (Spanish) IRS Form W-4 2023 Independent Contractor Invoice NEW Information For Agencies And Independent Contractors KCNS032 Instructions KS Adult Abuse, Neglect Exploitation Central Registry Release Of Information NEW KS COVID-19 Essential Worker Letter KS Child Abuse And Neglect Central Registry Release Of Information KS Criminal Background Check List Of Prohibited Offenses KS UHC Provider Enrollment Packet Blank (2023) NEW KS WORK Participant Direct Deposit Form (Fillable) NEW Payment Change Form NEW Provider Application Request Form Provider Change Of Information Form NEW Provider Checklist NEW Provider FAQ NEW Provider Information Form Provider Rate Change Form NEW SS 4 Form Instructions Separation Of Employment Form USCIS Form I 9 Instructions, Spanish (FOR REFERENCE ONLY) USCIS Form I 9, Spanish (FOR REFERENCE ONLY) USCIS Form I-9 USCIS Form I-9 Instructions Understanding Your Monthly Expenditure Report Vendor Payment Change Form NEW W9 Instructions Workers’ Compensation Claim Information NEW

Time4Care™

EVV Member Cover Letter EVV Member Faqs EVV Member Overview EVV Provider Cover Letter EVV Provider FAQs EVV Provider Overview EVV Quick Guide How To Download Time4care™ On Your Mobile Phone KS EVV FAQs Time4Care EVV Quick Guide Time4Care EVV Usage Feature – Members Time4Care EVV Usage Feature – Workers

BetterOnline™

Consumer Web Portal Guide Creating And Editing Participant Profiles Provider Web Portal Guide Updating ILC Information

Payroll Documents

Guide To Pend Messages On Timesheets And Invoices KS UHC Invoice Schedule 2024 KS UHC Pay Schedule 2024 Public Partnerships Mobile App Time4care Instructions Reimbursement Form Service Code List Technology Program Enhancements