The MO HealthNet Division publishes Hot Tips to supply information to clarify and assist in receiving timely reimbursement for services provided and claims disposition.

MO HealthNet has developed an index for historical and ongoing Hot Tips and a COVID-19 index for associated Hot Tips. The non-COVID-19 index location has not moved; it is also located below for quick reference.   Please share these Hot Tips with your billing staff.

Nursing Home Room & Board

January 31, 2023

With the exception of certain hospice stays, nursing home room and board is covered under fee-for-service (FFS) regardless of whether the resident is in a Managed Care health plan. Participants who are enrolled in a Managed Care health plan, and who are seeking admission into a nursing home, will remain in a their Managed Care health plan until a nursing home level of care is determined, or for 60 calendar days, whichever comes first. MHD must have verification that a DA-124 has been issued initiating the Department of Health and Senior Services level of care review before the 60 day process can begin. For more information, refer to Provider Bulletin, Volume 45, Number 22: Nursing Home Program – Revised.

Rural Citizens Access to Telehealth

February 1, 2023

The Rural Citizens Access to Telehealth (RCAT) project is a partnership between the Missouri Telehealth Network and MO HealthNet. Together, we will provide funding, education and training opportunities to introduce or enhance existing telehealth services for rural providers accepting Medicaid patients. If you are a provider that serves primarily rural populations in Missouri, are enrolled in MO HealthNet and provide primary and/or behavioral health care, please take our survey for more information.

Annual Reviews Coming: Partners & Providers: Help Spread the Word!

January 26, 2023

Very soon, the Family Support Division (FSD) will be required to check the eligibility of all MO HealthNet (Missouri Medicaid) participants, including Managed Care health plan members of Healthy Blue, Home State Health, and United Healthcare. This is called a Medicaid eligibility renewal (or annual renewal).

Partners & Providers: Help Spread the Word

More than 1.4 million Missourians have healthcare coverage through MO HealthNet and will be impacted by this change. We are asking partners, advocates, providers, and friends to help spread the word so Missourians can stay informed. You can help by:

To learn more about the Medicaid eligibility renewals, visit Frequently Asked Questions. You can also subscribe for email alerts, continue to check this website, or follow the Department of Social Services on Facebook, Instagram, or Twitter for updated information as it becomes available.

2023 Relias Training Schedule

January 23, 2023

MO HealthNet is offering FREE continuing education (CE) sessions for doctors, nurses, and pharmacists. Each session is created and presented by Relias and all are available as live webinars and will be recorded so you can earn continuing education credit on your own time. The list of topics and schedule is included in the attachment and on our MO HealthNet Provider Training Calendar. You do not need to be a MO HealthNet provider to register.

As trainings are confirmed, speakers and registration links will be added to the MO HealthNet Provider Training calendar.

  • To register: click on the Webinar Topic link of your choice in this training schedule.

Visit https://dss.mo.gov/mhd/providers/education/ to review MO HealthNet Division Education and Training Resources and to register for additional trainings offered by MHD.

Each session is for 1.0 CME hour for physicians, 1.0 CPE for pharmacists, and 1.0 contact hour for nurses.

In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Webinar must be attended in its entirety and attendees must complete the evaluation and post-test in order to receive the certificate of completion.

Relias helps healthcare leaders, human service providers, and their staff take better care of people, lower costs, reduce risk, and achieve better results.

Provider Communications Interactive Voice Response (IVR) Update

January 10, 2023

The Provider Communications IVR line has been updated! Providers call (573) 751-2896 for questions regarding claims, eligibility and more. When calling, there are five options to choose from:

1 – MO HealthNet Participant Eligibility
2 – Check Amount Information
3 – Claim Information
4 – Provider Enrollment Status
5 – MO HealthNet Participant Annual Review Date

Occasionally, providers have a question that is not covered by one of these options. MHD has added option 6 to be transferred directly to a representative. Option 6 is only for questions that do not fall in to the five categories above. As a reminder, you also have the option to message Provider Communications directly using the Provider Communications Management function on eMOMED. These messages will be responded to within three business days of receipt.

MO HealthNet participants can reach Participant Services at (800) 392-2161 or by emailing Ask.MHD@dss.mo.gov.

MHD Education and Training educates providers on proper billing methods and procedures for claim
filing and more. Contact Education and Training at MHD.Education@dss.mo.gov or (573) 751-
6683. For additional resources, visit the Education and Training Resources page.