CDPAP - Ideal Home Health

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CDPAP WITH IDEAL HOME HEALTH & PPL

CDPAP WITH IDEAL HOME HEALTH & PPL

How to Select Ideal Home Health as Your Facilitator

There are two ways to select Ideal Home Health as your CDPAP Facilitator:

Call Ideal Home Health Now! Call us now, and we’ll assist you in making the request with PPL while you’re on the line.
Submit Your Information! Complete the form on this page, and we’ll reach out to you to assist with facilitator selection.

Please note: The consumer must be present for both options.

Option 1: Let Ideal Home Health Assist You

We’ll call PPL with you, introduce ourselves as your facilitator, and have the consumer verify their information (DOB, Medicaid ID, full name, address, and more).
From there, we’ll confirm your selection in the portal, guide you through form signing, and finalize your CDPAP registration.

Option 2: Submitting Your Information

Fill out the following required fields in the form on this page:
- Consumer Name
- Consumer Medicaid ID
- Consumer Phone Number
Once verified, let the PPL representative know you’d like to request Ideal Home Health, Inc. as your CDPAP Facilitator.
From there, we’ll reach out to assist with form signing and finalizing registration!

Consumer First Name(Required)

Consumer Last Name(Required)

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Email

Phone(Required)

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Consumer SSN

Medicaid ID*(Required)

PA Name

PA Number

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Physical Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

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Consumer Date of Birth

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Designated Representative Name

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Designated Representative Phone

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Designated Representative Email

Preferred Language(Required)

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