Reimbursements
Dear Consumers of Department Services:
Each year the Department of Mental Health provides services for more than 100,000 Missourians and their families. Through its state-operated facilities and contract programs, the department assists persons with mental illnesses, developmental disabilities, and alcohol or drug abuse problems. It also provides services to persons who are compulsive gamblers.
This pamphlet is intended to explain how the department charges its clients for services. Unanswered questions should be addressed to the reimbursement administrator in the department's Office of Administration. The telephone number is 573-751-3398.
Sincerely,
Keith Schafer , Ed.D.
Director
KS:lt
Service costs shared by many
Caring for and treating people with mental illnesses, developmental disabilities, and those with substance abuse problems is expensive. In Missouri , such care can cost hundreds of dollars per day. Many families cannot bear the cost for this care and treatment alone. The Missouri Department of Mental Health is there to help.
Through its many programs, the Missouri Department of Mental Health provides assistance to thousands of persons. Many resources must be tapped to help recover costs incurred. The department, however, makes every effort to provide quality services to its clients while keeping costs as low as possible.
For example, third-party benefits are applied to offset costs first. Those benefits can come from private or public health insurance policies, or from Medicare or Medicaid.
If those payments are insufficient, a client or his family is asked to contribute a portion of the costs based on the family's ability to pay for care given to a client. Those charges are determined using a table that considers family size and income.
The table is administered by each individual facility. It is applied uniformly throughout the state and is reviewed annually.
Other assets are collected when the client is without spouse or dependents and determined to need full-time, long-term (inpatient or placement) care. In such cases, a client's earned and unearned income can be applied to costs. Unearned income, including benefits from disability, survivor's retirement, or pension plans, is used first. Examples of unearned income include payments by the Social Security Administration, the Veterans Administration, the Railroad Retirement Board, the Civil Service Commission and the Division of Family Services. Earned income from wages and salaries is charged if unearned income fails to cover costs.
However, a client is permitted to keep some income for personal spending. The amount, $30 a month or more, is determined by the team of professionals planning for a client's care.
Missouri law requires the Department of Mental Health to charge for the services it provides and to take certain steps to recover its costs. The charges to a client or his family, however, are kept to a minimum so services are affordable to all. Missouri law also requires the state to recover costs from a deceased client's estate. By sharing the costs with a client or his family, the department is able to offer better care. And caring is what the Department of Mental Health is all about.
Questions and answers about service charges
Q. The costs for providing health care seem so expensive. What is included in the costs to the department?
A. The department provides a wide variety of services, which are indeed expensive. Major expenses include room and board, nursing care, medical expenses, day treatment, family support services, and case management.
Q. Can charges to me exceed costs of the services provided?
A. No. The Department of Mental Health is required by law to determine charges and redetermine them each year. When private sources are employed to provide services, costs are set through contracts. Your charges are never allowed to exceed costs of the services provided.
Q. My child is over age 18. Am I liable for charges of services to him/her?
A. No. Parents are not liable from their incomes for the charges for services to their children ages 18 or older. Monies received by parents for their children in a fiduciary capacity are, however, subject to charges.
Q. My school-age child needs special education. Can I be charged for it?
A. No. A parent of a recipient ages 3 through 18 is not liable for costs of education or special education. You may, however, be charged for certain medical expenses, including medical supplies, chiropody medication, anesthesiology, oxygen therapy, radiology, electrocardiology, and electroencephalography. In addition, operating room, laboratory, dental, and physician's expenses are also chargeable. Parents are also asked to provide personal spending money.
Q. What items are considered personal expenses?
A. Clients' personal spending needs vary widely. A family may be asked to provide money for cigarettes, candy, or soft drinks. Other items, such as clothes, jewelry, games, and some toiletries are also the family's responsibility.
Q. If two members of my family received services in the same month, must I pay double?
A. No. Your monthly ability to pay is the same amount regardless of how many visits you receive in that month. It is the same for any number of family members being seen. It is the responsibility of the client or family to notify the provider if two or more members receive services in the same month.
Q. Am I required to provide documents to verify my income, assets, and dependents?
A. Yes. A client or his family must divulge financial resources, using such documents as pay stubs, the most recently filed tax return, employer verification of income, etc. If you fail to provide the documents, you become responsible for all costs.
Q. What if I fail to comply with requests for insurance information, assigning benefits, or applying for benefits (i.e. Medicaid, Social Security, VA benefits)?
A. You will be charged the full cost of services with no regard to income and size of family.
Q. My financial status changed after I submitted my income documentation and I make less money now. Must I continue to pay the same amount?
A. Not necessarily. If your financial situation changes, you should submit new information and request a review of your financial status. Charges to you would be adjusted, if appropriate.
Q. When are my bills due?
A. Bills for each month's services are mailed the following month. They are payable upon receipt.
Q. What can I do if I believe my charges are unfair?
A. You may appeal your charges only if you believe your assessment was inaccurately calculated. An appeal to the director cannot be made because you disagree with your share of the payment. It must be based on what you believe is an inaccurate calculation of allowable exemptions under Standard Means Test rules.
Q. What if I fail to pay the costs assigned to me through the Standard Means Test procedure?
A. The state will pursue other means to receive payment; for example, the Income Tax Intercept Program and any other means allowable under state and federal law.
Q. I can't afford to pay for the care my family member needs. Can we be turned away?
A. No. The department has never refused to provide services to someone unable to pay. However, if the department finds you can pay and won't, the department reserves the right to refrain from providing services.
Q. What if I am covered by insurance and the Department of Mental Health is not an approved provider?
A. You must go to an approved provider or pay the full cost of services.
Q. Where can I get further information?
A. Contact the administrator at your local facility.
You should provide the following information when requesting services for individuals from a Department of Mental Health facility.
- Insurance company name and address
- Insurance policy or group number
- Medicare number
- Medicaid number
- Proof of Income
- Proof of Dependents
- Social Security number of client, spouse, or parents of a minor child
To receive information on the Standard Means Test, contact any of the following:
State facilities serving persons with mental illnesses and mental disorders and their families:
St Louis Psychiatric
Rehabilitation Center
5300 Arsenal
St. Louis , MO 63139
(314) 877-6500
FAX (314) 877-5982
Hawthorn Children's
Psychiatric Hospital
1901 Pennsylvania
St. Louis , MO 63133
(314) 512-7800
FAX (314) 512-7812
Fulton State Hospital
600 E. 5 th St.
Fulton , MO 65251-1798
(573) 592-4100
FAX (573) 592-3000
Northwest Missouri Psychiatric
Rehabilitation Center
3505 Frederick
St. Joseph , MO 64506
(816) 387-2300
FAX (816) 387-2329
Southeast Missouri
Mental Health Center
1010 West Columbia
Farmington, MO 63640
(573) 218-6792
FAX (573) 218-6703
Southwest Missouri Psychiatric
Rehabilitation Center
1301 Industrial Parkway East
El Dorado Springs , MO 64744
(417) 876-1002
FAX (417) 876-1004
Mid-Missouri Mental Health Center
3 Hospital Dr.
Columbia, MO 65201
(573) 884-1300
FAX (573) 884-1010
Western Missouri
Mental Health Center
600 East 22 nd St.
Kansas City , MO 64108
(816) 512-7000
FAX (816) 512-7509
Metropolitan St. Louis
Psychiatric Center
5351 Delmar
St. Louis , MO 63112
(314) 877-0500
FAX (314) 877-0553
Missouri Sexual Offender
Treatment Center
1016 West Columbia
Farmington, MO 63640
(573) 218-7045
FAX (573) 218-7053
Cottonwood Residential Treatment Services
1025 North Sprigg St.
Cape Girardeau , MO 63701
(573) 290-5888
FAX (573) 290-5895
State residential facilities serving persons with mental retardation and other developmental disabilities and their families:
Bellefontaine Habilitation Center
10695 Bellefontaine Rd.
St. Louis, MO 63137
(314) 340-6000
FAX (314) 340-6199
Higginsville Habilitation Center
100 W. 1st St ., PO Box 517
Higginsville, MO 64037
(660) 584-2142
FAX (660) 584-6244
Marshall Habilitation Center
Slater St., PO Box 190
Marshall, MO 65340
(660) 886-2201
FAX (660) 831-3071
Nevada Habilitation Center
2323 North Ash
Nevada, MO 64772
(417) 667-7833
FAX (417) 448-1138
St. Louis Developmental
Disabilities Treatment Centers
211 N. Lindbergh
St. Louis, MO 63141
(314) 340-6702
FAX (314) 340-6724
Southeast Missouri Residential Services
2351 Kanell Blvd.
Poplar Bluff, MO 63901
(573) 840-9370
FAX (573) 840-9373
State regional offices serving persons with mental retardation and other developmental disabilities and their families:
Albany Regional Office
809 N. 13th St.
Albany, MO 64402
(660) 726-5246
FAX (660) 726-5615
Central Missouri Regional Office
1500 Vandiver Dr., Suite 100
Columbia, MO 65202
(573) 882-9835
FAX (573) 884-4294
Hannibal Regional Office
805 Clinic Rd., PO Box 1108
Hannibal, MO 63401
(573) 248-2400
FAX (573) 248-2408
Joplin Regional Office
3600 E. Newman Rd., PO Box 1209
Joplin, MO 64802
(417) 629-3020
FAX (417) 629-3026
Kansas City Regional Office
821 E. Admiral Blvd.
PO Box 412557
Kansas City, MO 64106
(816) 889-3400
FAX (816) 889-3325
Kirksville Regional Office
1702 E. LaHarpe
Kirksville, MO 63501
(660) 785-2500
FAX (660) 785-2520
Poplar Bluff Regional Office
2351 Kanell Blvd., PO Box 460
Poplar Bluff, MO 63901
(573) 840-9300
FAX (573) 840-9311
Rolla Regional Office
105 Fairgrounds Rd.,
PO Box 1098
Rolla, MO 65402
(573) 368-2200
FAX (573) 368-2206
St. Louis Regional Office, North
211 North Lindbergh
St. Louis, MO 63141
(314) 340-6500
FAX (314) 340-6666
St. Louis Regional Office, South
111 N. 7th St., 6th Floor
St. Louis, MO 63101
(314) 244-8800
FAX (314) 244-8804
Sikeston Regional Office
112 Plaza Dr., PO Box 966
Sikeston, MO 63801
(573) 472-5300
FAX (573) 472-5308
Springfield Regional Office
1515 East Pythian, PO Box 5030
Springfield, MO 65801 -5030
(417) 895-7400
FAX (417) 895-7412
For information on community programs that serve individuals who misuse or are addicted to alcohol or other drugs and their families:
Western Missouri
Mental Health Center
2600 E. 12 th St.
Kansas City, MO 64127
(816) 482-5770
FAX (816) 482-5774
St. Louis Psychiatric
Rehabilitation Center
Dome Building
5400 Arsenal
Mail Stop A-419, 4th Floor
St. Louis, MO 63112
(314) 877-0370
FAX (314) 877-0392
Department of Mental Health
1706 E. Elm St.
Jefferson City , MO 65101
(573) 751-8090
FAX (573) 751-7814
The Jefferson City address of the Department of Mental Health Central Office is:
Department of Mental Health
1706 E. Elm St.
P.O. Box 687
Jefferson City , MO 65102
(573) 751-4122
FAX (573) 751-8224
http://www.dmh.mo.gov
The Department of Mental Health does not deny employment or services because of race, sex, creed, marital status, national origin, disability, or age of applicants or employees.
Examples of forms used in the application of the Standard Means Test can be found on the following pages. They are:
Standard Means Test Financial Questionnaire, and Notice of Cost.
Standard Means Test Financial Questionnaire
Questionnaire, pg. 2
