Registration Application

How do supplemental health care service agencies register with the Department of Health and Senior Services?

Affected agencies must submit the registration application via online or mail, and each registration application must be accompanied by an $830 initial registration fee or a $700 renewal registration fee. Initial Registration applications and fees should be received as soon as possible to legally operate in Missouri and be in compliance with section 198.642 RSMo.

*The easiest way to register is via the online application.*

MO 580-3424 Application for Registration to Operate a Supplemental Health Care Services Agency

OR

Agencies may register by submitting one pdf document with your agency name as the title or clearly within the document to our drop box link: SHCSA Drop Box

Each separate business location from which the agency operates in Missouri shall have a separate application. (Please note the agency office does not have to be located in Missouri, any office location that provides health care personnel to a Missouri health care facility must register).

Fees must be payable to the Department of Health and Senior Services in the form of a cashier’s check, personal or certified check, company check, money order, or through the on-line payment system by credit card or e-check. A registrant may mail their fee to the Department of Health and Senior Services, Fee Receipt Unit, PO Box 570, Jefferson City, MO 65102-0570. *If mailing a fee, please include with fee: Name of Agency/DBA, Contact Person, Contact Person Phone #, and Physical Address as listed on the registration application. Follow this link if paying online: https://health.mo.gov/about/online-payment.php and scroll down to click on “Pay Online”. Then click Yes to continue.

What is acceptable documentation for financial responsibility in the registration application?

Please refer to the Financial Documentation FAQ

What to expect when submitting my registration application and applicable fee:

After a registration has been submitted online or received via mail, registrants should receive an auto email from drlnotifications1@gmail.com confirming the registration has been received. *Do not respond to the auto email, it is not a monitored inbox*

Please allow at least ten (10) business for SHCSA staff to begin processing your registration application. If we have any questions or need additional information, we will email the agency email and responsible contact person email listed in the registration application.

Once a registration application and fee have been reviewed and accepted, an email copy of the registration certificate and applicable information from drlnotifications1@gmail.com will be sent to the agency email and responsible contact person email listed in the registration application. If you have not received contact from the SHCSA office regarding the status of your registration application, please check your spam/junk folder and/or reach out to SHCSA@health.mo.gov.

How long is my registration valid?

An agency’s registration is valid for one (1) year and shall expire on the annual anniversary of the date the registration was originally issued. An agency’s renewal application must be received at least sixty (60) days prior to the expiration of the current registration.