HCBS providers may choose to participate in the reassessment of participants of Division of Senior and Disability Services (DSDS) that they serve by becoming a Type 27 provider.

Enrollment in the provider reassessment program is voluntary. Enrolled providers will conduct the reassessments during face-to-face visits utilizing the InterRAI HC assessment. For participants whose HCBS provider is not enrolled as a Type 27 provider or those with multiple HCBS providers, the reassessment will be completed by either DSDS staff or their designee.

 

Participation Requirements

Participation in the provider reassessment process is voluntary. If a Home and Community Based Services (HCBS) provider chooses to participate they must meet all requirements outlined below.

  • HCBS providers must be assigned a Medicaid provider type 27 number by Missouri Medicaid Audit and Compliance (MMAC) to participate and receive payment.
  • Participation in provider reassessment training is required for all assessors. HCBS providers who offer training to qualified assessors must attend a Division of Senior and Disability Services (DSDS) sponsored training. All assessors must meet the qualifications below.
    • Licensed Registered Nurse (RN), or
    • A bachelor's degree from an accredited college or university.
  • SharePoint registration is required to obtain reassessment assignments. To register for SharePoint, contact DSDS HCBS Systems and Data Reporting Unit at providerreassessments@health.mo.gov and provide the following:
    • Provider agency name
    • Medicaid provider type 27 number
    • Contact name
    • Contact telephone
    • Contact e-mail
  • All Protected Health Information (PHI) must be exchanged securely. HCBS providers must either have their own encryption software or utilize the Proofpoint software initiated by DSDS.

For HCBS providers who choose to subcontract with another qualified entity, provider agency or individual assessor to complete participant reassessments, the following guidelines have been established by DSDS. It is recommended that any HCBS provider who utilizes this option consult with their legal representative before finalizing the contract.

  • Be enrolled as a Medicaid provider type 27 with MMAC. The enrolled HCBS provider is responsible for billing MO HealthNet Division for the reassessment.
  • Ensure the subcontracting entity is a qualified assessor and maintain proof of the assessor’s qualifications and training on-site for monitoring purposes.
  • Assign the participant reassessments to the subcontractor. The assignments on SharePoint are only to be accessed by the enrolled HCBS provider. Log in information shall not be shared with subcontractors.

Training

Division of Senior and Disability Services (DSDS) provides training for new provider assessors to ensure consistent application of Home and Community Based Services (HCBS) policy related to reassessments. HCBS reassessment providers are responsible for ensuring that all qualified assessors have participated in the reassessment training and passed the exam.

Registering for provider reassessment training is required. At the time of registration, the trainee must submit proof of qualification to DSDS. Email confirmation will be sent by DSDS upon reviewing of enrollment.

All trainings have been cancelled due to COVID-19. Watch for training updates through DSDS e-news.

For attendees who have been present for the entire training session, an exam is given at the conclusion of the training. An attendee must pass the test with an 80% in order to have successfully passed the training and receive a certificate. The only individuals permitted to test without attendance in the training session are those who have previously attended training and are present for the purpose of retesting.

Training certification must be maintained in the assessor’s personnel file and made available upon DSDS or MMAC request.

Type 27 providers shall ensure that all assessors receive and review DSDS updates of policy and procedure information regarding reassessments that is disseminated by DSDS through HCBS Policy Memos and INFO Memos. To receive electronic notification of updates all HCBS providers are to subscribe to DSDS E-News.

Process

Distribution Process

Standardized criteria is applied to determine assignment of reassessments. Only those assigned to the provider by Division of Senior and Disability Services (DSDS) are to be completed. Home and Community Based Services (HCBS) providers may only bill for reassessments assigned by DSDS. The assignments located on SharePoint will include all participants the provider should reassess within 90 days. HCBS providers are expected to review their assigned reassessments monthly to identify participants who no longer need a reassessment.

Assessment/Care Planning Process

Provider reassessors are acting on behalf of DSDS, and are therefore held to the same expectations of DSDS assessors. Providers are expected to follow policy and procedure outlined in the reassessor training, HCBS Manual, and other DSDS resources to include the following actions in the HCBS Web Tool:

  • Updating the Participant Case Summary Screen
  • Entering complete and accurate assessment information
  • Creating a pending care plan
  • Thoroughly documenting the reassessment visit in Case Notes
  • Documentation and uploading of all required forms.

Return/Notification Process

All HCBS Provider reassessments and corresponding documentation should be entered into CyberAccess Web Tool upon completion of the reassessment, but no later than the 15th day of the month in which the reassessment is due. Delaying entry of reassessments or documentation into CyberAccess Web Tool should not occur for any reason. The DSDS Provider Reassessor Review Team should be notified promptly once the reassessment and required documentation has been entered into CyberAccess Web Tool.

If, for any reason, an HCBS Provider is unable to complete the reassessment process by the set deadline (the 15th day of the month in which the reassessment is due), the DSDS Provider Reassessor Review Team must be notified immediately, but no later than the 15th day of the month in which the reassessment is due. The DSDS Provider Reassessor Review Team will complete any reassessments not entered, completed, and/or notified by the 15th day of the month in which the reassessment is due. Coordination and notification with the DSDS Provider Reassessor Review Team should occur through encrypted email to ProviderReassessmentReview@health.mo.gov.

Provider reassessments will be reviewed and approved by the end of the month they are due. DSDS will review the reassessment to ensure all requirements are met and documented appropriately. If determined the reassessment is incomplete, the provider will be contacted for additional information and/or remediation. Providers should complete all requested remediations within two business days of request to ensure authorizations are completed on time. If unable to obtain the information from the reassessor, the reassessment is considered incomplete and the provider should not request reimbursement.

Please check Cyber Access Web Tool to access information related to each participant’s reassessment status. If there are participants without an approved care plan on the first of the month following the due date, notify the DSDS Provider Reassessor Review Team through encrypted email to ProviderReassessmentReview@health.mo.gov.

Reimbursement Process

Providers will be reimbursed $75.00 per completed reassessment assigned to their agency. The provider will electronically file their claim for the completed reassessments with eMOMED per Department of Social Services (DSS), MO HealthNet (MHD) requirements. The procedure code for reassessments is T1028TS and the diagnosis code is Z02.89. Any billing concerns should be addressed to MHD’s Interactive Voice Response (IVR) at 573-751-2896.

Registration and Communication

Home and Community Based Services (HCBS) reassessment providers shall:

    • Registration for SharePoint to access reassessment assignments. Provide the following when requesting SharePoint access:
      • Provider agency name
      • Medicaid provider type 27 number
      • Contact name
      • Contact telephone
      • Contact e-mail
    • Communicate issues involving utilization of SharePoint or accessing assigned reassessments.
    • Inform DSDS of any changes impacting the reassessment process or assignments. This includes changes to a provider agency name, contact information, or e-mail update.

For questions related to the reassessment process contact DSDS HCBS Systems and Data Reporting at providerreassessments@health.mo.gov.

Web Tool Information

Check out the Web Tool Reassessment Guide for step by step instructions.

For more information on the HCBS CyberAccess Web Tool, visit the Web Tool site at www.health.mo.gov/webtool.

Need help with Web Tool? Email the support team at DSDSWebTool@health.mo.gov.