Interactive Voice Response (IVR) System
Providers can access the MO HealthNet Division (MHD) Interactive Voice Response (IVR) system by calling (573) 751-2896. The IVR allows active MHD provider inquiries for the following options:
International Classification of Diseases (ICD) MO HealthNet Claim Filing Guidelines
MO HealthNet Division (MHD) providers filing claims should choose the correct International Classification of Diseases (ICD) code. The date of service will determine whether the diagnosis code set value must be ICD-9th revision or ICD-10th revision. The date of service determines the ICD code, not the filing date. Providers are encouraged to file claims on the MHD electronic billing portal, emomed.
ICD-10 is Nearly Here
Starting with dates of service on October 1, 2015, and later, claims will require an International Classification of Diseases (ICD), 10th Revision, Clinical Modification (CM)/Procedure Coding System (PCS), medical diagnosis and/or inpatient procedure code. While October 1, 2015, is fast approaching, there is still time to transition to ICD-10. Centers for Medicare & Medicaid Services (CMS) provide many free tools and resources at www.cms.gov/icd10.
Non-Emergency Medical Transportation Program
The Non-Emergency Medical Transportation (NEMT) Program may be utilized by participants to receive transportation to their MO HealthNet covered medical appointment. The NEMT broker is LogistiCare Solutions, LLC.
To arrange transportation for an eligible participant, call 1-866-269-5927, Monday through Friday, 8:00 AM to 5:00 PM, at least 5 calendar days before an appointment. Urgent appointments and hospital discharges may be called in 24 hours a day, 7 days a week.
Claims Processing and Payment Schedule for Fiscal Year 2016
Please access the Claims Processing Schedule for Fiscal Year 2016, for the updated claims processing schedule located on the fiscal agent’s website.
Missouri Medicaid Audit and Compliance Screening Requirements
State and federal regulations, 13 CSR 65-2.020, require all currently enrolled MO HealthNet Division (MHD) providers to revalidate their enrollment at least every five (5) years. MMAC has established a revalidation schedule for all currently enrolled providers.
Missouri Medicaid Audit and Compliance Enrollment or Revalidation Process
All MO HealthNet Division (MHD) providers are required by federal regulations, 42 CFR 455, and state regulations, 13 CSR 65-2.020, to disclose certain information to Missouri Medicaid Audit & Compliance (MMAC), during their initial enrollment
Provider Address Changes
Missouri Medicaid Audit & Compliance (MMAC) is implementing new provider enrollment procedures, including provider revalidation. Any provider, whose address has changed since initial enrollment, should submit the updated information to MMAC by accessing the “Provider Update Request” form and submitting the changes to MMAC.
Missouri Medicaid Audit and Compliance
The Missouri Medicaid Audit and Compliance (MMAC) website posts information for MO HealthNet Division (MHD) providers and participants. On the MMAC website, the "Contact Us" tab allows users to contact MMAC with their questions. Please utilize this function to submit questions directly to MMAC.
Securing and Protection of Health Information
Please protect and secure health information.
Tips for Protecting Protected Health Information (PHI):
- Do not leave PHI, such as reports, claims, medical documentation, and other sensitive information, in a car.
- Double-check fax numbers. Faxing is secure, when it is sent to the correct fax number.
- If you maintain PHI on a flash drive, ensure the drive is encrypted to prevent unauthorized access.
- Shred PHI when it is no longer needed. Double-check to ensure PHI is going in the shred container