Palco is proud to be supporting Conduent and the New Mexico Human Services Department with the Mi Via program and Self-Directed Care Benefit (SDCB). For more information on these programs, visit: www.hca.nm.gov
Below you will find resources and forms to support your program enrollment. If you need assistance with the forms, you should contact the Consolidated Customer Service Center at 1.800.283.4465, choose option 5. All forms should be submitted to Conduent as directed on the packets via Email: docprocessing@conduent.com or Fax: 866-302-6787.
Palco se enorgullece de apoyar a Conduent y al Departamento de Servicios Humanos de Nuevo México con el programa Mi Via y el Beneficio de atención autodirigida (SDCB). Para obtener más información sobre estos programas, visite: www.hca.nm.gov
A continuación, encontrará recursos y formularios para respaldar su inscripción en el programa. Si necesita ayuda con los formularios, debe comunicarse con el Centro de Servicio al Cliente Consolidado al 1.800.283.4465, elige la opción 5. Todos los formularios deben enviarse a Conduent como se indica en los parquetes. Email: docprocessing@conduent.com o el Fax: 866-302-6787.
For the New Mexico Veteran-Directed HCBS program, please click here:
Mi Via and Self-Directed Community Benefit Documents
News & Updates
April Newsletter
May Newsletter
June Newsletter
July Newsletter
August Newsletter
December Newsletter
Money Network Cards for Vendor Payments
Money Network Card Demo 3/13/2023 AM Session
Money Network Card Demo 3/13/2023 AM Session Transcript
Money Network Card Demo 3/13/2023 PM Session
Money Network Card Demo 3/13/2023 PM Session Transcript
Money Network Card Demo 3/15/2023 AM Session
Money Network Card Demo 3/15/2023 AM Session Transcript
Money Network Card Demo 3/15/2023 PM Session
Money Network Card Demo 3/15/2023 PM Session Transcript
User Guides
Agency Authenticare User Guide – UPDATED
EVV Workstreams
EVV HSD-MAD Information Session – 12/21/2020
EVV Telephony User Guide – Provider and Self-Directed Vendor Agencies
EVV Mobile Application User Guide – Provider and Self-Directed Vendor Agencies
Training & FAQs
EVV Agency Training Slides
EVV Agency Mobile Application Training Slides
DDW & Supports Waiver Agency Based Post Go-Live Information Session 1/15 – PDF
EVV Frequently Asked Questions
EVV Vendor Agency FAQ
EVV Forum Q&A
EVV Mobile Application FAQ – Provider and Self-Directed Vendor Agencies
EVV Agency Training Recording Link
EVV Agency Mobile App Training Recording Link
DDW & Supports Waiver Agency Based Post Go-Live Information Session 1/15 – Video
EVV Post Go-Live FAQ – DDW & Supports Waiver – 1/15/2021
Spanish
Agency AuthentiCare User Guide – Spanish
EVV Forum Q&A – Spanish
EVV Frequently Asked Questions – Spanish
EVV Mobile App FAQ – Provider and Self-Directed Vendor Agencies – Spanish
EVV Mobile App User Guide – Provider and Self-Directed Vendor Agencies – Spanish
EVV Vendor Agency FAQ – Spanish
EVV Workstreams – Spanish
User Guides
EVV Telephony User Guide – Direct Hire Employees
Authenticare Telephony Mi Via E-Codes
EVV Telephony User Guide – Direct Hire Employees – Spanish
EVV Workstreams
EVV Workstreams – Spanish
Training Slides/FAQs
EVV Training Slides
EVV Training Slides – Spanish
EVV Mi Via Training Slides
EVV Mi Via Training Slides Spanish
Mi Via EVV Exemption Code Guidance
Mi Via Post Go-Live Information Session 1/15 – PDF
EVV Frequently Asked Questions
EVV Frequently Asked Questions – Spanish
EVV Post Go-Live FAQ – Mi Via – 1/15/2021
Employer Forms
New Employers:
Employer Packet – Full
Current Employers:
IRS Form ACD 31102
SS-4 Form
Misc. Forms:
Money Network Card
Request Form for Employers
Employer Money Network Card FAQs
Money Network Card
Reimbursement Request Form
Authorized Agent Form
Intake Forms:
Participant Referral and Intake Form
Worker Forms
New Employees:
Pre-Hire Packet
Worker Packet – Full
Pay Rate Changes:
Employment Agreement
Update W-4s:
2026 Federal W-4 Form
2026 State W-4 Form
Employer Change:
Employment Agreement
Payroll Information Worksheet
Payment Options:
Pay Selection and Direct Deposit Form
Process for Payment Forms:
Employee 2 Week Timesheet
Employee 2 Week Mileage
Updating Demographics/Name:
Change of Information Form
Misc Forms:
2025 Payroll Schedule
2026 Payroll Schedule
Employment Separation Notice
Stop Payment Request Form
Money Network Card
Reimbursement Request Form
Money Network Card Validation Form
Income Verification Form
Intake Forms:
Worker Intake Form
Vendor Forms
New Vendors:
Providing Services:
Vendor Enrollment Packet
Providing Goods:
Vendor Information Form
Employer Change:
Vendor Agreement Form
Payment Options:
Pay Selection and Direct Deposit Form
Process for Payment Forms:
Vendor Payment Request Form
Non-Timesheet Invoice
Vendor Mileage Request Form
Return to Provider (RTP) Updates
Update Demographics/Name:
Change of Information Form
Misc Forms:
2025 Vendor Payment Schedule
2026 Vendor Payment Schedule
Stop Payment Request Form
Vendor Separation Notice
Employer Forms
New Employers:
Employer Packet – Full
Current Employers:
IRS Form ACD 31102
SS-4 Form
Misc. Forms:
Money Network Card
Request Form for Employers
Employer Money Network Card FAQs
Money Network Card
Reimbursement Request Form
Authorized Agent Form
Intake Forms:
Participant Referral and Intake Form
Worker Forms
New Employees:
Pre-Hire Packet
Worker Packet – Full
Pay Rate Changes:
Employment Agreement
Update W-4s:
2026 Federal W-4 Form
2026 State W-4 Form
Employer Change:
Employment Agreement
Payroll Information Worksheet
Payment Options:
Pay Selection and Direct Deposit Form
Process for Payment Forms:
Employee 2 Week Timesheet
Employeee 2 Week Mileage
Updating Demographics/Name:
Change of Information Form
Misc Forms:
2025 Payroll Schedule
2026 Payroll Schedule
Employment Separation Notice
Stop Payment Request Form
Money Network Card
Reimbursement Request Form
Money Network Card Validation Form
Income Verification Form
Intake Forms:
Worker Intake Form
Vendor Forms
New Vendors:
Providing Services:
Vendor Enrollment Packet
Providing Goods:
Vendor Information Form
Employer Change:
Vendor Agreement Form
Payment Options:
Pay Selection and Direct Deposit Form
Process for Payment Forms:
Vendor Payment Request Form
Non-Timesheet Invoice
Vendor Mileage Request Form
Return to Provider (RTP) Updates
Update Demographics/Name:
Change of Information Form
Misc Forms:
2025 Vendor Payment Schedule
2026 Vendor Payment Schedule
Stop Payment Request Form
Vendor Separation Notice
Empleadores y Trabajadores
Aviso de Rescisión de la Relación Laboral
Calendario de Pagos de Palco – 2025
Cambio de Información
Contrato de Empleo
Paquete de Inscripción del Empleador
Autodirigido/Participante de NM
Paquete Para el Empleado de Servicio Autodirigido y de Participantes de NM
Registro de Empleados
Remisión y Admisión de Participantes
Paquete de Percontratación de Autodirigido/Participante de NM
Formulario de Solicitud de Suspensión de Pago y de Reexpedición de Cheques
Designación de Participante/Autodirección de Agente Autorizado/Representante Personal
Instrucciones de AuthentiCare IVR