Reassessment Packet

Reassessments

Home and Community Based Services providers may choose to participate in the reassessment of participants of the Department of Health and Senior Services, Division of Senior and Disability Services (DSDS) that they serve.  This service only applies to personal care, aged & disabled waiver and adult day care services authorized by the DSDS.  Additional information is available at http://health.mo.gov/seniors/hcbs/memos.php

To be considered for enrollment, the following application packet must be submitted:

Reassessment Packet

Provider Questionnaire

Enrollment Application

Participation Agreement

Business Organizational Structure Form

Electronic Funds Transfer – Paper

       OA Vendor Input/ACH-EFT

Current documentation from DSDS of completed Reassessment Training registration and attendance (email notice, memo, certificate)

Submit the application packet via mail, fax, or email.  Emailing documents in PDF or Word format is acceptable.  MMAC does not accept picture file attachments for enrollment purposes.

Email:  mailto:mmac.ihscontracts@dss.mo.gov

Fax Number:  573-634-3105

 

Mailing Address:

Missouri Medicaid Audit & Compliance Unit
Provider Enrollment – Contracts
PO Box 6500
Jefferson City, MO  65102

 

Physical Address:

Missouri Medicaid Audit & Compliance Unit
Provider Enrollment – Contracts
205 Jefferson Street, 2nd Floor
Jefferson City, MO  65101