Provider Home Page
Announcements and Admin/Med Resources
Contact Provider Relations
Frequently Used Forms
Most forms are PDF or Fillable PDF. (?)
Get Acrobat Reader | PDF Problems?
Online Claim Submission
Provider Directory
Additional Programs
Complex Case Management Program
- Diagnoses/Conditions
- Referral and Contact Info
- What Providers Can Expect
- What Members Can Expect/Testimonials
Disease Management Programs
Obesity Management (HeLP)
Special Health Care Needs
Lead Poisoning Prevention
Clinical Practice Guidelines
Cross-Cultural Resource Guide
Contact Provider Relations
Sign up for email newsletter
Give us your feedback!
Missouri Provider Updates
(scroll down for Provider Forms / Resources)
Claims Address: P.O. Box 411806, Kansas City, MO 64141-1806
Electronic Payor ID: Emdeon: 43173, Gateway EDI: 00173, Relay Health: 43173, SSI: 99999-0027
Companion Guide KS 837P: PDF Word Companion Guide KS 837I: PDF Word
Electronic Payor ID: Emdeon: 43173, Gateway EDI: 00173, Relay Health: 43173, SSI: 99999-0027
Companion Guide KS 837P: PDF Word Companion Guide KS 837I: PDF Word
ANNOUNCEMENTS
01/27/2012: NEWSFLASH January 2012 Newsletter
10/31/2011: Missouri Providers: Children's Mercy Establishes New Integrated Pediatric Network to
Coordinate Care for Pediatric Medicaid Patients and News Release
Manuals/Resources/Quick Guides
Autism Resources
Case Management Quick Guide
HEDIS Quick Guide
Clinical Practice Guidelines
Lead Quick Reference Guide
Prior Authorization Quick Guide
Provider Administration Manual (PAM)
Provider FAQs
Provider Newsletters
MO HealthNet Home Page
MO HealthNet Support and Forms
MO HealthNet Bulletins
MO HealthNet Medicaid Fee Schedule
Commonly-Used Forms (see all forms)
Claim Adjustment/Correction (fillable)
Electronic Funds Transfer (EFT)
Abortion Consent Form
Prior Authorization Form
Hysterectomy Consent Form
Pregnancy Risk Screening/Notification Form (PNF)
Sterilization Consent Form
PCP Change (member) (fillable)
Practice Change Form
Third Party Liability (TPL) (fillable)
