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Some crossover claims cannot be processed in the usual manner for one of the following reasons:

  • The provider’s National Provider Identifier (NPI) number is not on file in the MO HealthNet Division’s (MHD) provider files. If you are in doubt as to what NPI number is on file, you should contact the Provider Enrollment Unit by e-mail at mmac.providerenrollment@dss.mo.gov.
  • The Medicare contractor does not send crossovers to MHD. For instance, Medicare Advantage/Part C plans do not forward electronic crossover claims to MHD. Therefore, providers must submit Medicare Advantage/Part C crossover claims through the MHD Web portal at www.emomed.com.
  • The provider did not indicate on the claim to Medicare that the beneficiary was eligible for MO HealthNet.
  • The MHD participant information on the crossover claim does not match the fiscal agent’s participant file.