MO HealthNet providers that find they were paid incorrectly for claims resulting in overpayments may use the Self-Disclosure process to repay the overpaid amounts. In order to ensure provider-initiated self-disclosures are processed quickly and efficiently, a form is located on the Missouri Medicaid Audit and Compliance (MMAC) website, located here.
Self-disclosures can be processed quickly when they contain all the necessary information:
the reason for the self-disclosure if the overpayment is a sampling, and if so, a description of the method used internal control number(s) (ICN) and the amounts associated with the services or products that were billed participant names and Medicaid numbers (DCN) dates of service total amount being refunded, and name and telephone number of the person preparing the self-disclosure
This process does not replace the EMOMED adjustment/credit process. Claims meeting the adjustment/credit time period may still be processed through EMOMED.
Please do not send a check when self-disclosing drug claims. These claims will be adjusted/credited by MMAC staff. Providers will be notified if a check is needed.
Please contact mmac.financial@dss.mo.gov with any questions.
