MO HealthNet Division 615 Howerton Court P.O. Box 6500
Jefferson City, MO 65102-6500 Telephone: (573) 751-3425
Web page: www.dss.mo.gov/mhd/
Participant Services 800-392-2161 or 573-751-6527: The Participant Services Unit is available for MO HealthNet participants to access an
Interactive Voice Response (IVR) system that can address participant coverage, Medicare,
Qualified Medicare Beneficiary (QMB), private insurance, and premium collections inquiries.
Provider Communications 573-751-2896: The Provider Communications Unit is available for MO HealthNet providers to access an
IVR system that can address participant eligibility, last two check amounts, claim status inquiries,
provider enrollment status, and annual review date. The Provider Communications Unit also processes written
inquiries. Written inquiries should be sent to:
Provider Communications Unit
PO Box 5500 Jefferson City, Missouri 65102
Pharmacy and Medical Pre-Certification Help Desk 800-392-8030 Providers can call this toll free number to: request a pre-certification for a radiological
procedure (CAT scan and MRI); to 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;
to request information on Medicare Part D; or, to request a drug prior authorization.
The MO HealthNet fax line for non-emergency service or equipment exception requests only is (573) 522-3061;
the fax line to obtain a drug prior authorization is (573) 636-6470. Do not
use either of these numbers for requests for pre-certifications of MRI and CAT scan procedures.
Effective July 17, 2006, MHD implemented pre-certification for certain radiological
procedures (CT and MRI). In order for providers to be reimbursed for these services, the participant
must meet certain medical criteria and the physician must obtain the pre-certification for the procedure
unless performed in an inpatient hospital or emergency room setting. Approved pre-certification requests
are given a 14 day approval period.
The list of medical imaging procedures and durable medical
equipment and supplies that currently require pre-certification along with the related medical criteria can
be referenced at the MO HealthNet Web site www.dss.mo.gov/mhd/cs/medprecert/pages/medprecert.htm.
Before initiating a request, providers are encouraged to sign up for the MO HealthNet web tool - CyberAccess -
which automates the pre-certification process. To become a CyberAccess user, contact the Conduent help desk
at 1-888-581-9797 or 573-632-9797, or send an e-mail to CyberAccessHelpDesk@conduent.com.
The CyberAccess tool allows each request for pre-certification to automatically reference the individual
participant's claim history, including ICD diagnosis codes and CPT procedure codes. Requests for
pre-certification will also be taken by the MO HealthNet call center at 800-392-8030 option 2.
Requests must meet medical criteria established by MHD in order to be approved.
Psychology Help Desk 866-771-3350 Clinical Exception, Psychology/Counseling Prior Authorizations
Provider Education 573-751-6683 Provider Education Unit staff are available to educate providers and other groups on
proper billing methods and procedures for MO HealthNet claims.
Contact the Unit for training information and scheduling.
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 Enrollment The Provider Enrollment Unit's page is accessed through the Missouri Medicaid Audit and Compliance website at
http://mmac.mo.gov/.
Providers can contact Provider Enrollment at
MMAC.ProviderEnrollment@dss.mo.gov
, or through the 'Contact Us Form' on the website or by calling (573)751-3399.
Provider Revalidation Providers can contact Provider Revalidation at
MMAC.Revalidation@dss.mo.gov
, or by calling (573) 751-5238.
Wipro Infocrossing 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 Infocrossing
Internet billing service. You may also contact the help desk via email at
help.desk@momed.com
For more information about the MO HealthNet Division and the services we provide, email us at
Ask.MHD@dss.mo.gov
