Provider Participation

Providers must be enrolled in the MO HealthNet program to provide medical services. Those who participate in the MO HealthNet Program agree to accept MO HealthNet payment as reimbursement in full for any services provided to MO HealthNet participants. A participant cannot be billed for the difference between the MO HealthNet payment and the provider's billed charges. MO HealthNet Managed Care services are provided in accordance with the terms and conditions of the contract between MHD and the MO HealthNet Managed Care health plans. Participants enrolled in MO HealthNet Managed Care access services through the health plan's provider network. The health plan network may include providers not enrolled in the fee-for-service program.

Provider Quick Links

Hot Tip of the Week
Pre–Certification Criteria Documents

Provider Options

Education and Billing

RA remark codes and claim adjustment reason codes
Nursing Facility Claims FAQ
MO HealthNet Training Workshops updated 04/29/08
- Training Booklets
On-Line Host Presentation Training updated 06/11/08

General Information

Fee Schedules
MO HealthNet Guide — Puzzled by the Terminology? This printable guide explains the various MO HealthNet terms and codes. updated 07/01/08
Provider FAQ

Provider Enrollment

Apply - to become a MO HealthNet provider
Civil rights - compliance information
Enrollment guide - information and requirements for new applicants and existing providers
Provider Enrollment FAQ

Provider Manuals