Provider Reassessment Process
Standardized criteria are 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 shall not bill for any reassessment that was not assigned unless communicated and approved 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.
All face-to-face reassessments and necessary documentation must be completed and entered into the Web Tool no later than the 15th day of the month it is due. The reassessments are to be entered as soon as possible upon completion and should not be held for any reason. The DSDS Regional Evaluation (REV) Team should be notified promptly upon entry of the reassessment and documentation into the Web Tool. Notification can occur through an encrypted email or a fax. If an HCBS provider is unable to complete the reassessment process by the 15th day of the month it is due, contact with the REV Team must be made immediately.
A calendar is available reflecting dates that are essential to the reassessment process.
Providers are expected to follow policy and procedure outlined in the reassessor training and the HCBS Manual 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
Additionally, the following documents are to be entered into the HCBS Web Tool upon completion of the reassessment:
- HCBS Care Plan and Participant Choice Statement Form (with participant signature) / Instructions (Agency, CDS, and ADC).
- Adult Day Care Participant Rights and Responsibilities
- Agency Model Participant Rights and Responsibilities
- CDS Participant Rights and Responsibilities
- Participant Choice Statement Form (with participant signature) / Instructions (RCF/ALF)
- HCBS Assessment Attestation Form / Instructions
- In-Home Services Worksheet / Instructions if utilized in building the care plan.
- Consumer-Directed Services Worksheet / Instructions if utilized in building the care plan.
- Any additional forms or screening tool utilized during the reassessment process (i.e. St. Louis University Mental Status (SLUMS) examination. Form / Instructions
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. If unable to obtain the information from the assessor, the reassessment is considered incomplete and the provider should not request reimbursement. For specific instruction on entering the reassessment information into the HCBS Web Tool, refer to the Reassessment Guide.
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.