PROVIDER COMMUNICATIONS
573-751-2896
MO HealthNet providers can contact the Provider Communications Unit with inquiries, concerns or questions regarding proper claim filing, claims resolution and disposition, and participant eligibility questions and verification. The IVR (Interactive Voice Response) system is accessed by calling the 573-751-2896 number. The IVR system can address participant eligibility, last two check amounts and claim status inquiries. At anytime during the IVR options, providers may select “0” to speak with the next available specialist. Calls are put into a queue and will be answered in the order received. Providers must use a touchtone phone to access the
IVR.
Providers may send and receive secure E-mail inquiries to MO HealthNet Provider Communications and Technical Help Desk Staff. This application is available through the MO HealthNet Web portal at www.emomed.com. Once logged in and on the eProvider page, click on the ‘Provider Communications Management’ icon, this opens the ‘Manage Provider Communications’ page. From here, click on ‘New Request’ to open the ‘Create New Request’ form to enter and submit an inquiry. Providers are limited to one inquiry per E-mail. The user submitting the E-mail inquiry will be notified via E-mail when they have a response available to their inquiry.
The Provider Communications Unit also responds to written inquiries. Written inquiries should be sent to:
Provider Communications Unit
PO Box 5500
Jefferson City, Missouri 65102
WIPRO INFOCROSSING HEALTHCARE SERVICES, INC. HELP DESK
573-635-3559
Call this number for assistance in establishing the required electronic claims and remittance advice formats, network communication, HIPAA trading partner agreements and assistance with the Wipro Infocrossing Internet billing service.
PROVIDER ENROLLMENT
Providers are required to notify Missouri Medicaid Audit Compliance, Provider Enrollment Section regarding changes to their Provider Master File. Changes include, but are not limited to, physical address, tax identification, ownership, individual’s name or practice name, or NPI number. Changes may be reported via E-mail at mmac.providerenrollment@dss.mo.gov or by mail to:
Missouri Medicaid Audit and Compliance
Provider Enrollment Section
PO Box 6500
Jefferson City, Missouri 65102
THIRD PARTY LIABILITY
573-751-2005
Call the Third Party Liability Unit to report injuries sustained by MO HealthNet participants, problems obtaining a response from an insurance carrier, or unusual situations concerning third party insurance coverage for a MO HealthNet participant.
PROVIDER EDUCATION
573-751-6683
Provider Education Unit staff are available to educate providers and other groups on0 proper billing methods and procedures for MO HealthNet claims. Contact the unit for training information and scheduling. Providers may also send E-mails to the unit at
mhd.provtrain@dss.mo.gov.
PARTICIPANT SERVICES
800-392-2161 or 573-751-6527
The Participant Services Unit assists participants regarding access to providers, eligibility, covered and non-covered services and unpaid medical bills.
MO HEALTHNET PHARMACY AND CALL CENTER
800-392-8030
Providers can call this toll free number to:
• Request pre-certification for specific DME items;
• Initiate an emergency request for an essential medical service or an item of equipment that would not normally be covered under the MO HealthNet program;
Providers are encouraged to sign up for the MO HealthNet Web tool – CyberAccessSM – which automates the pre-certification process. To become a CyberAccessSM user, contact the Xerox Care and Quality help desk at 888-581-9797 or 573-632-9797 or
send an E-mail to CyberAccessHelpdesk@xerox.com. The CyberAccessSM tool allows each pre-certification to automatically reference the individual participant’s claim history, including ICD-9 diagnosis codes and procedure codes.
• Request information on Medicare Part D,
• Request a drug prior authorization; or,
• Request medical pre-certification for a CT scan or MRI.
