CDS complaints and appeals · Missouri
Grievances and appeals
A grievance is a complaint about Communicare Elite, and you raise it with us. An appeal challenges a MO HealthNet decision that denied, reduced, suspended or ended your CDS services, and it goes to the state under the deadline printed on your notice.
Two different things get confused here, and confusing them wastes time that appeal deadlines do not forgive.
A grievance is about us
Late pay, a rude staff member, an unreturned call, a timesheet problem nobody fixed, an attendant behaving badly. You raise it with Communicare Elite.
An appeal is about a state decision
Your services were denied, reduced, suspended or ended, or your care plan was cut. That is a MO HealthNet decision. You appeal it to the state — we cannot overturn it.
How do you file a complaint about Communicare Elite?
- Tell us. Call us, email info@communicareelite.com, or write to us at 4477 Woodson Rd, Suite 106, St. Louis, MO 63134. Include what happened, when, and who was involved.
- We acknowledge it and tell you who is handling it.
- We look into it — records, timesheets, staff accounts.
- We respond with what we found and what we are doing.
- If you are not satisfied, say so. You can escalate to the Department of Health and Senior Services at 866-835-3505, and you can change vendors at any time.
Complaining does not put your services at risk. We do not retaliate, and you do not need our permission to leave. Switching vendors →
How do you appeal a MO HealthNet decision about your CDS services?
If MO HealthNet denies, reduces, suspends or terminates your services, you have the right to a fair hearing. The notice you receive will state the decision, the reason, and how to appeal.
- Read the deadline on the notice and act on it. Appeal rights expire, and missing the date is the most common way people lose a case they would have won.
- Ask about continuing services. In some circumstances services continue at the current level while an appeal is pending if you file quickly enough. Ask when you file, not later.
- Keep the paperwork. The notice, your care plan, and anything supporting your need for the hours.
- Get supporting evidence. A letter from your physician describing your functional limitations often carries real weight.
- You may bring someone — a family member, an advocate or a lawyer.
We can supply the service records we hold to support your appeal. We cannot represent you, and we cannot change the decision.
Who else can help with a CDS complaint or appeal in Missouri?
- Missouri Department of Health and Senior Services — HCBS line, 866-835-3505.
- Missouri Protection and Advocacy Services — the state’s designated protection and advocacy system for people with disabilities.
- Your local Center for Independent Living — advocacy and benefits help for people with disabilities.
- Legal Services of Eastern Missouri — free civil legal help for those who qualify.
Something gone wrong? Tell us.
Call us for a free consultation, or text us. We serve St. Louis City, St. Louis County and Missouri communities within about 40 miles of our office.
Frequently asked questions
Will complaining put my CDS services at risk?
No. Complaining does not put your services at risk. Communicare Elite does not retaliate, and you do not need our permission to leave. You can change CDS vendors at any time. If you are not satisfied with how we handled your grievance, you can escalate it to the Missouri Department of Health and Senior Services at 866-835-3505.
Do my services continue while an appeal is pending?
In some circumstances, yes. Services can continue at the current level while an appeal is pending if you file quickly enough, so ask about continuing services when you file, not later. Read the deadline printed on your notice and act on it. Missing that date is the most common way people lose a case they would have won.
Can Communicare Elite overturn a MO HealthNet decision?
No. A decision that denies, reduces, suspends or ends your services is a MO HealthNet decision, and you appeal it to the state through a fair hearing. We can supply the service records we hold to support your appeal, but we cannot represent you and we cannot change the decision. You may bring a family member, an advocate or a lawyer.
What evidence helps a CDS appeal?
Keep the notice, your care plan and anything that supports your need for the hours. A letter from your physician describing your functional limitations often carries real weight. We can also supply the service records we hold. Legal Services of Eastern Missouri offers free civil legal help to those who qualify, and your local Center for Independent Living can advocate.