Thank you for visiting the Online Forms Submission System. This website is for providers delivering service to Medicaid participants on the Aged & Disabled (A&D) Waiver or Personal Care Services including participants that are on the Medicare Medicaid Coordinated Plan (MMCP) and Idaho Medicaid Plus (IMP).

Completing the forms on this system is fast and easy with no faxing required.

1. Download the PDF form

2. Complete the form in its entirety

3. Upload the completed form on this website and it will be routed to the appropriate staff member

All forms are in a PDF format and include electronic signatures for the provider and participant.

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If you require assistance, please email BLTCCentral@dhw.idaho.gov

First Time User Registration

To have full access to the Online Forms Submission System, including receiving the most up to date version of all forms please enter your email below and select SUBSCRIBE.

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CASE MANAGEMENT: Following are a list of interactive forms for Case Management. Select the OPEN icon and complete the form in it’s entirety and select Submit. The form will be sent to the BLTC automatically. A PDF version will also be populated to download for your records. IMPORTANT: This form must be completed online.

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The following is a list of all fillable forms available online. The forms are to be used for both adult and child participants unless otherwise specified. Please carefully review the document name and description to ensure you are downloading the correct form. To download a PDF form, select the document by clicking on the document name and select Download to my Computer

Download to my Computer

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To Upload Completed PDF forms, please select the Upload button in blue below.

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There are two ways to upload Completed PDF Forms

1. Select the Browse button

Navigate to the files on your computer
Select the files that you want to upload
Click the Open Button
Verify that the correct PDF form is to be uploaded
Select the Upload button

2. Open your windows explorer

Navigate to the files on your computer
Select the files that you want to upload
Drag and drop the files over the Select files field located left of the Browse button
Verify that the correct PDF form is to be uploaded
Select the Upload button

3. Do you have a Service Plan to upload?

Yes

4. Do you have a Family Personal Care Request form to upload?

Yes

5. Do you have a RN Supervisory Visit form to upload?

Yes

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