MO HealthNet Provider Hot Tip of the Week
Provider Addresses Must Be Kept Current
Missouri Regulation 13 CSR 70 – 3.020(7) requires providers to inform the state of any changes affecting their MO HealthNet enrollment records. These changes, including change of address, are to be reported by the provider on specific forms within 90 days of the change (except for change of ownership or control, which must be reported within 30 days). In addition, section 2.2 of the MO HealthNet Provider Manual requires providers to notify the Provider Enrollment Unit (PEU) of a change of address.
In Missouri, these updates and changes are reported to the PEU at Missouri Medicaid Audit and Compliance (MMAC).
In accordance with the regulation above, the PEU at MMAC inactivates enrolled providers whose mail has been returned to MMAC or MO HealthNet as undeliverable. This action suspends providers’ claims for 180 days, during which time the claims are neither paid nor denied. If the provider does not submit an address update form to PEU by the end of the 180 days, the provider’s claims will then be denied. This is done to help ensure provider enrollment records are accurate. Upon receipt and processing of the required form for updates, provider numbers are reactivated by the PEU.
In order to update your address with Provider Enrollment, please submit a Provider Update Request form. If you know your enrollment has already been made inactive due to undeliverable mail, write RETURNED MAIL in the upper right hand corner of the Update Request form. This will alert Provider Enrollment staff to forward any mail that has been returned.
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Older Archived Hot Tips
The MO HealthNet Division provides weekly tips to providers to assist them in receiving timely reimbursement for services provided. As each new tip is posted, existing ones are archived on the same site for easy reference. Please share these weekly tips with your billing staff.