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• Make necessary changes in the Demographic screen in the facility module of ICCIS. If the provider is in theapplication process to become licensed the Designee will forward the information to the assigned Licensing Specialist to make the change. • Designees must send via email or fax the State of Alaska Substitute Form W-9 to the CCPO Accounting Staff at: ccpo@alaska.gov using subject line “ICCIS Facility Mailing Address Change.”

b. The CCPO Accounting Staff will within two (2) business daysof receiving the State of Alaska Substitute Form W-9: • Compare the State of Alaska Substitute Form W-9 to the mailing address in ICCIS to ensure they are the same. If they are not the same, the form is returned to the Designee to update ICCIS. After confirming the address and updating ICCIS, the Designee must resend the State of Alaska Substitute Form W-9; • Access the provider’s information inIRIS; o If the address in IRIS matches the State of Alaska Substitute Form W-9 it is filed in the provider’s billing file and no further action is needed; or o If the address in IRIS does not match the State of Alaska Substitute Form W-9, the form is emailed to DOF to update IRIS; and • Email the Designee the changes have been made to the provider’s mailing address in IRIS. The DOF process usually takes three (3) to five (5) business days.

3. In-home Provider In-home providers do not submit a State of Alaska Substitute Form W-9. A mailing address change may be reported verbally or in writing.

The Designee will make necessary changes in ICCIS to the Demographic screen in both the family and provider modules in ICCIS. 4300-1 F. PHYSICAL LOCATION Providers are approved or licensed at a specific physical location. When a provider relocates a new case is not created in ICCIS. Changes may be reported verbally or in writing and are documented in an ICCIS case note.