September 7, 2023
Participant direction helps people live the life they choose. That includes choosing vendors that best fit their preferences. In Ohio, this service is called Participant Directed Goods and Services (PDGS). It is available to people enrolled in the Level One and SELF waivers.
GT’s Role in Participant Directed Goods and Services (PDGS)
As the financial management service (FMS), GT Independence enrolls the participant’s chosen vendors. We also make sure that the vendors submit the correct documentation. This helps the goods and services authorized in the individual service plan get approved and paid for with fewer delays.
The Process of Purchasing Goods
The participant identifies chosen vendors
- If the participant is new to GT, the participant identifies the vendors they have chosen at the enrollment meeting
- If the participant is already active with GT, the participant contacts GT Customer
Service to add or remove vendors - This step lets GT know what vendors need to be enrolled so the participant can
receive goods authorized in the individual service plan
GT enrolls the vendor
- GT reaches out to the vendor to complete the enrollment documents and explain the required documentation
- The vendor must complete the required enrollment documents below to provide
goods:
- Purchase of Service Agreement which is the agreement between the Participant and Vendor
- Preferred Payment Method Form so that GT can pay the vendor
- Medicaid Provider Agreement so the vendor knows the rules of accepting Medicaid payment
- W-9 Form so that GT can report taxes correctly for vendor payments
The vendor cannot provide goods until the services are authorized, the documents are complete, and GT alerts the vendor that they are active.
To purchase goods
- The participant submits a purchase request form that includes the date of the request, the participant’s name, details and price of the good, and the preferred vendor
- The purchase request form is important to make sure the good is approved and can be purchased timely
GT purchases the goods
- GT confirms the good is approved in the participant’s individual service plan and not on the excluded item list
- Gift cards of any kind cannot be purchased
- GT purchases the good based on the payroll schedule
The Process of Paying for Services
The participant identifies chosen vendors
- If the participant is new to GT, the participant identifies the vendors they have chosen at the enrollment meeting
- If the participant is already active with GT, the participant contacts GT Customer
Service to add or remove vendors - This step lets GT know what vendors need to be enrolled so the participant can
receive services authorized in the individual service plan
GT enrolls the vendor
- GT reaches out to the vendor to complete the enrollment documents and explain the required documentation
- The vendor must complete the required enrollment documents below to provide services:
- Purchase of Service Agreement which is the agreement between the Participant and Vendor
- Preferred Payment Method Form so that GT can pay the vendor
- Medicaid Provider Agreement so the vendor knows the rules of accepting Medicaid payment
- W-9 Form so that GT can report taxes correctly for vendor payments
The vendor cannot provide service until the services are authorized, the documents are complete, and GT alerts the vendor that they are active.
To have a vendor paid for services
- After the service has been provided, the vendor must submit an invoice to GT that includes the participant’s name, description of service, and the date the service was provided
- The invoice must be signed by the participant or the participant must submit a purchase request form to match the invoice
- The documents with all of the required information are important to make sure the service is approved and so that GT can pay the vendor on time
GT pays for services
- GT confirms the service is approved in the participant’s individual service plan and not on the excluded item list
- GT reimburses the vendor for the approved service based on the payroll schedule
Excluded items list
Excluded items per OAC 5123-9-45 (D)(2) include:
- Experimental treatments
- Items used solely for entertainment and recreation
- Pools, spas, and saunas
- Tobacco products or alcohol
- Food
- Internet service
- Items of general utility
- New equipment or repair of item damaged as a result of confirmed misuse
- Same type of supplies and devices without documented change in condition that warrants replacement
- Items that are illegal or prohibited by law
- Home modifications that add to the total square footage or are of general utility
- Other items as specified
Have more questions? Contact us.
We’re here to support you every step of the way.
Call: 877.659.4500
Email: customerservice@gtsd.org