Cash Receipts Assessment Program

User ID and Password

We have enhanced the Cash Receipts Assessment Program web application to allow Residential Health Care Facility (RHCF) providers to file electronically via the Internet. If you choose this option, you will need to complete form DOH-4412. This form is used to apply for the user ID and password and is required to utilize electronic filing. You will also be required to complete and sign a Monthly Cash Receipts Assessment Report Certification form to be submitted each time an electronic submission is filed. Monthly Cash Receipts Assessment Report electronic filing is designed to be very user friendly. A help desk has been established to aid those requiring assistance. Further, we encourage you to make payments electronically via Wire Transfer. Should you have any questions or comments concerning filing reports electronically, please contact the electronic filing help desk at (315) 671-3800.