The MO HealthNet Division (MHD) Medicare Unit is updating their system to become paperless. The MHD Medicare Unit’s preferred correspondence method with providers will be by email or fax.
Providers need to update their email addresses and fax numbers to receive MHD Medicare letters and billing statements.
The HCY Program is a comprehensive, primary and preventative health care program for MO HealthNet Division (MHD) eligible children and youth under the age of 21. The MO HealthNet Division Provider Manuals Section 9 describes the HCY Program.
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:
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.
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.
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.
Please access the Claims Processing Schedule for Fiscal Year 2016, for the updated claims processing schedule located on the fiscal agent’s website.
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.
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
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.
