The Provider Enrollment Unit is responsible for enrolling new providers in accordance with 13 CSR 70-3, maintaining provider records, and answering provider inquiries related to enrollment for all MO HealthNet provider types. The Provider Enrollment staff is authorized and required to determine when new provider numbers are issued or when a current provider number will be updated.
After a MO HealthNet provider number has been issued it must be used with all transactions pertaining to MO HealthNet. If a separate provider number has been issued for different location/practices, the provider is responsible to ensure the appropriate provider number is used when billing. Learn more about provider enrollment.
Contracts
The Contracts staff reviews proposals submitted by entities who wish to contract with MMAC to provide In-Home Services (IHS) or Consumer Directed Services (CDS) to participants authorized by the Department of Health and Senior Services (DHSS).
Revalidations
State and federal regulations require all currently enrolled Medicaid providers to revalidate their enrollment at least every five (5) years.
State and federal regulations (13 CSR 65.2 and 42 CFR 455.414) require all enrolled Medicaid providers to do certain things:
- Revalidate their information at least every five (5) years
- Certain providers must pay an application fee
- Providers must be screened according to categorical risk level
- Ordering, referring, and prescribing providers must be enrolled
Please click on “Providers” at the top of this page, and choose “Provider Enrollment” to see further information on each one of these categories.