Adaptive Equipment/Assistive Technology

What is it?

  • Adaptive Equipment services include:  performing assessments to identify type of equipment needed, devices, controls or applicances to increase individuals' abilities to perform activities of daily living, or to perceive, control, access or communicate with the environment in which they live.
  • Assistive Technology devices are:  items, pieces of equipment or product systems, whether commercial, modified or customized.  These devices are used to increase, maintain or improve functional capabilities of individuals.  Individuals are assisted in the selection, acquisition and use of an assistive technology device.

How Do I Become A Provider?

  1. You must submit an IRS W-9 form  and required supporting documentation to DHS, Division of Developmental Disabilities:
    • EMAIL:  DHS.DDDMedProv@illinois.gov
      Illinois Department of Human Services Division of Developmental Disabilities
      600 East Ash Street, Building 400, Mail Stop 2
      South Springfield, IL 6270
      Attention: Provider Enrollment
    1. The IRS W-9 form must be completed accurately.  Please review the IRS W-9 Guidelines for instructions on how to complete the form based on your company's tax classification. 
    2. The IRS W-9 Guidelines will also provide instructions on the supporting documentation that may be required for some companies and LLLCs.  Please submit any required supporting documentation with the IRS W-9. 
    3. You will receive an email notification from DHS.DDDMedProv@illinois.gov when the W-9 has been certified and registered with the Illinois Office of the Comptroller. 
  2. Submit an IMPACT Provider Enrollment application for the company AFTER you have received notification that the IRS W-9 for you company has been certified:
    1. You, the person sitting at the computer, must create an IMPACT account on the IMPACT login page.  Enter the information required for this step using your personal information and NOT the company's.
    2. After creating this account, apply for approval of a Single Sign-On ID.  Please use the Single Sign-On ID PowerPoint Presentation found on the IMPACT Presentations and Materials page on the HFS website to complete this step. 
    3. When the Single Sign-On ID has been approved, return to the IMPACT login page and log into your account. 
    4. Click on NEW ENROLLMENT.
    5. On the next screen, select the Enrollment Type:  Atypical Agency.
    6. Use the Atypical Agency PowerPoint Presentation as found on the IMPACT Presentations and Materials page on the HFS website to complete this step. In addition to the instructions provided on the PowerPoint, you must enter the information listed below on the application.
      1. Add Specialty: Assistive Equipment; Adaptive Equipment/Assistive Technology; No Subspecialty
      2. Associate Provider: DDD Billing Provide ID number 7094718
      3. Associate Billing Agent: DDD Billing Agent number 7094638
      4. Associate MCO Plan: DDD MCO Plan ID number 3000006
  3. Send an email to DHS.DDDMedProv@Illinois.gov notifying DDD Provider Enrollment that the IMPACT enrollment application has been completed and submitted an IMPACT application for State Review. 
  4. You will receive an email notification when the IMPACT application has been approved.