MO HealthNet Division (MHD) Provider Enrollment manages new enrollments, maintains active records, and assists providers across all MO HealthNet program types. Once issued, the MO HealthNet provider ID must be used for all program transactions. If a provider’s practice operates across multiple locations with distinct provider IDs, the provider is responsible for billing under the correct location-specific number. MHD Provider Enrollment retains sole authority over issuing new numbers or updating existing ones.
Applications from new, reenrolling and revalidating Medicaid providers are processed in accordance with state regulations 13 CSR 65-2 and 13 CSR 70-3.020. Reenrollment is different than revalidation. A reenrolling provider is an individual or institution that was previously active but is in an inactive status at the time an application is submitted to MMAC. Revalidation means there is no break in active status. All currently enrolled (active) MO HealthNet providers must go through a revalidation process at least every five (5) years to continue to be a MO HealthNet provider.
To ensure compliance, every provider application undergoes the same process, regardless of whether a provider is already enrolled at another location. Applications or reviewed in the date order they are received. Returned applications awaiting missing information, as well as denied online applications that must be resubmitted, do not receive priority processing.
The links below provide additional information on provider enrollment and revalidation:
- Centers for Medicare & Medicaid Services (CMS)
- Civil Rights Compliance information
- Enrollment Application Fee
- Enrollment Site Visits
- Fingerprint Based Criminal History Checks
- Home and Community Based Service Providers
- Individual Provider Enrollment Flow Chart
- Office of Inspector General Exclusions Database
- Ordering, Prescribing & Referring (OPR) Providers
- Organized Health Care Delivery System (OHCDS) Providers
- Provider Assigned Risk Categories
- Provider Enrollment Forms