Children's Mercy Family Health Partners - Missouri Provider Resources

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Contact Information

View important phone numbers and provider reps by county here.

Forms

Acknowledgement of receipt of Hysterectomy Form & Information
Claim Adjustment Form
EPSDT Form / HCY Screening: Please complete this form at the member's well-child visit and include it in their permanent medical record.
MO HealthNet Forms Request
Online Claims Submission Signup Form
Pregnancy Notification Form: **Instructions** Please mail or fax (forwarding information noted on the form) this completed form to CMFHP to notify us of a pregnant member. NOTE: The Appraisal for Pregnant Women Form may be used in lieu of the CMFHP form.
Prior Authorization Form
Provider Update Form
(Sterilization) Consent Form
Primary Care Provider Change Form
Beneficiary Bank Info For EFT

Office Resources

Training

Provider Newsletters

2008
October
May
April
2007
November
September
2006
September
May
February
2005
September
February
2004
September
April

Billing

Claims Address
P.O. Box 411806
Kansas City, MO 64141-1806

Electronic Payer ID
WebMD: 43173
Gateway EDI: 00173
SSI: 43173

Companion Guides
FHP Inbound 837I Companion Guide
FHP Inbound 837P Companion Guide

Other Helpful Information

Child Health Library - The library includes a database of more than 1,000 child health topics as well as a single site to access all of Children's Mercy's child health information resources: Care Cards, Med Cards, Well Child Cards, Healthy Kids University classes, new podcasts and video interviews, and much more.
Children’s Mercy Family Health Partner’s Speaker’s Bureau - A catalog of available speaker’s dealing with children’s health issues in conjunction with Children’s Mercy Hospitals and Clinics. To schedule a speaker for your group contact Diana Kelley with the Community Relations Department at 816-855-1889.
DMS Website
Missouri Medicaid Bulletins
Missouri Medicaid Fee Schedule
See what Children's Mercy Family Health Partners can do for its members
Pharmacy Claim Form