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 firstname.lastname@example.org with any questions.