Contact Your Adult Services Worker (ASW)
Upon completion of the CHAMPS enrollment application if you already have a beneficiary who needs to be authorized for services contact your beneficiary’s Adult Services Worker (ASW).
The ASW will schedule a face-to-face meeting with you and your beneficiary. The new provider must be present for this meeting.
Submit the MSA-1904
Once services have been provided submit the MSA-1904 which include an accurate record of the authorized Home Help services that were provided on each day of the billing period. A separate MSA-1904 must be submitted for each beneficiary in which services were provided.
Payment will not be released until the MSA-1904 has been received and verified by the beneficiary’s local county MDHHS office.
Click MSA-1904 to download a fillable version of the invoice.