Unlocking the Secrets to Medicaid Certification for Assisted Living

Jul 23, 2025

Medicaid is one of the best ways to get paid consistently while serving people who truly need care. But let’s be honest—it can also feel overwhelming and confusing when you're first starting out.

Where do you even begin? What forms do you need to fill out? Who do you talk to when things don’t make sense?

This guide will walk you through every step you need to take to apply for Medicaid certification for your assisted living business.

Let’s get into it! 🔍💼

Check out this video, too:

Medicaid Enrollment vs. Certification: What’s the Difference?

First, let’s clear up something that trips up a lot of people: the difference between enrollment and certification.

✅ Enrollment is the first step. It means applying to your state Medicaid program so you can become a recognized provider.
✅ Certification comes next. That’s when you go through the approval process with each individual payer—like Molina, UnitedHealthcare, or your state’s own health department.

💡 Some states have just one Medicaid payer, which makes things easier. Others have multiple, which means you may need to fill out more than one application, depending on who your residents are insured through.

This is why staying organized is so important. Each payer might need slightly different information!

Step 1: Gather These 3 Must-Have Documents

Before you even start the application process, make sure you’ve got these documents ready. These are your non-negotiables. You’ll use them again and again.

📄 State License – This shows that your facility is legally allowed to provide care in your state.
🛡️ Certificate of Insurance (COI) – Get this from your insurance broker. You can usually log in and download it directly from their portal, or just ask them to generate one for you.
🏦 Bank Verification – Different payers may ask for different versions of this. Some want:

A voided business check
A letter from your bank on their letterhead
A document showing your account and routing numbers
✅ Wet (handwritten) signatures, not digital ones

If you’re not sure what to submit, ask the payer directly to avoid delays.

Step 2: Create a Medicaid Folder to Stay Organized

🎯 Pro tip: Create a digital folder in Google Drive, Dropbox, or OneDrive just for Medicaid documents.

In this folder, include:
✅ Your state license
✅ Your COI
✅ Bank account verification documents
✅ Business ownership records
✅ Any past or in-progress Medicaid applications
✅ Tax ID/EIN info
✅ NPI number if you have one

By keeping everything in one place, you’ll save time every time you fill out a new form—and avoid making small mistakes that could hold up your approval.

Step 3: Get Ready to Answer These Common Questions

Whether you're applying to the state or a managed care organization, they’re going to ask some standard questions. Be ready to answer clearly and confidently.

Here are some examples of what they might ask:

Who owns the facility or business?
What is the full facility address and mailing address?
What services do you offer (transportation, respite, memory care)?
Who do you serve—seniors, disabled adults, something else?
Do you have an administrator or nurse on staff?

✍️ If you’re unsure how to answer these, that’s a sign you need a business plan.

➡️ Download the Free Business Plan Checklist to get clear on your vision and prepare strong answers.

Step 4: What’s an NPI and Do You Need One?

Most states do not require a NPI (National Provider Identifier) for an assisted living facility—but some Medicaid applications ask for it anyway (usually because their application is more general and some of the providers they credential do need an NPI).

Here’s how to know:

❌ If your facility only provides non-medical care, you probably don’t need an NPI.
✅ If you bill Medicare, or provide nursing or medical services, you do.

Still confused? No problem. Just reach out to the payer and ask:
“Do I need an NPI for this application?”

They’ll usually be able to give you a quick answer. It's better to ask questions early than to get rejected later.

Step 5: Watch Out for Multiple Payers in Your State

In many states, Medicaid is split between multiple organizations. These are called managed care organizations (MCOs), and each one may have their own process.

Let’s take Idaho as an example:

Payer 1: Idaho Health & Welfare (the state)
Payer 2: Molina Healthcare
Payer 3: UnitedHealthcare

Each of these requires a separate application, even though they all fall under Medicaid.

That means:
📄 3 applications
📞 3 follow-ups
🗂️ 3 sets of paperwork

It’s extra work, but once you’ve got your Medicaid folder set up with all your documentation, it becomes a lot easier to submit duplicate information quickly.

Step 6: Protect Your Personal Information on Public Portals

Here’s something many people overlook: when you apply for Medicaid, your application info may become public—especially if it’s posted in a state or county provider directory.

That means:
⚠️ Your name
⚠️ Your email
⚠️ Your phone number
⚠️ Your address

may show up online.

To stay safe and professional:
✅ Use a business email and phone number
✅ Set up a business address or PO box if you work from home (or don't want a specific address posted online)
✅ Keep your personal info separate from business forms

A few extra steps now can save you a lot of unwanted spam (or worse) later.

Next Steps: Take Action Today!

Ready to stop guessing and get Medicaid certified?

Here’s your quick-start plan:

✅ Step 1: Download the Business Plan Checklist
✅ Step 2: Set up a Medicaid folder with all your documents
✅ Step 3: Apply for the Assisted Living Investing Mastermind for expert coaching.

You’ve got this. Take it one step at a time, and soon you’ll be helping people and getting paid with confidence. 💪

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