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Welcome to the 2024 Fourth Quarter edition of the MO HealthNet Provider Newsletter!
Our goal is to open the lines of communication between the MO HealthNet Division (MHD) and healthcare providers.
We're glad you're here!
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In This Edition:
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My MO HealthNet Member Portal
MHD has created a new resource for participants. Announcing the new My MOHealthNet Member Portal!
This Portal allows MO HealthNet participants to:
- View their MO HealthNet account details
- Report other health insurance
- Complete Managed Care Health Risk Assessments for themselves and their family members
- Report their Primary Care Provider information
- Change their Managed Care health plan (if they meet requirements)
- Disenroll from their Managed Care health plan
Participants who owe a premium (Spend Down, CHIP, and Ticket to Work) can view, print, and pay invoices on their account. Payments can be made by either the participants credit/debit card or banking information. Paying an invoice in full on the Portal will provide them with next day coverage. Participants are also able to view correspondence normally mailed to them from the MO HealthNet Division regarding their benefits and coverage.
To use the Portal, the head of household must create an account on the My MOHealthNet Member Portal. To do this, they will need their DCN or Social Security Number, and their date of birth. The participant must have active MO HealthNet coverage to create an account.
If a participant is having issues with the My MOHealthNet Member Portal, please have them call (800) 348-6627 to speak to a Choice Care Counselor.
Participants can also visit the Welcome to MO HealthNet Healthcare Coverage site to find a provider, compare Managed Care health plans, review Frequently Asked Questions, and more. No account is required to access this information. Participants should continue to report changes for their household, such as their address, expenses, reporting a pregnancy, etc. on Report a Change.
MO HealthNet Community Connection
Providers: Please share with your MO HealthNet participants.
The MO HealthNet Community Connection (formerly Member Forum) is an opportunity for MO HealthNet participants to share their opinions and speak to MO HealthNet Division (MHD) team members about the services and care they receive through MO HealthNet or the Managed Care Health Plans.
Participants can voice any concerns or provide feedback by taking a brief survey.
For more information, visit the MO HealthNet Community Connection.
Healthy Children and Youth Program
Did you know that MHD sends letters to families whose children haven’t had their well checks in the last year?
The letter informs the parents of the benefits available to their children, and other relevant resources.
It also provides a QR code to the Healthy Children and Youth program. Once there, parents can watch a short video that explains their benefits. Also, this webpage can be translated into 80 different languages!
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Telemedicine Place of Service (POS) Codes
Effective December 22, 2024, the MO HealthNet Division (MHD) will accept POS 10 and 27 on Telemedicine claims. POS 10 indicates that services are provided to the patient in their home. POS 27 indicates that services are provided to the patient at an outreach site/street, such as a non-permanent location on the street or found environment.
Also on this date, POS 02 will indicate that telemedicine services are being provided to a participant outside of their home, in a location such as a hospital or other facility.
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 Program of All-Inclusive Care for the Elderly (PACE)
A new webpage regarding the Program of All-Inclusive Care for the Elderly (PACE) was created for participants. PACE is administered by the MO HealthNet Division and Medicare to provide comprehensive health care, social, recreational, and wellness services to their participants. One of the main goals of PACE is to allow older adults to live safely in their homes instead of nursing facilities.
To be eligible for PACE, participants must meet the following criteria:
- 55 years of age or older
- Meet Missouri’s criteria for nursing home level of care
- Live in the service area for the PACE Organization
- Be able to live safely in the community
This new PACE page gives an overview of the program, what services are included, eligibility information, FAQs, and how to connect with a PACE Organization.
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MHD Education & Training will be hosting an in-person Behavioral Health Billing and Policy Workshop on December 3rd in Jefferson City! Providers will have the opportunity to speak to the Behavioral Health Policy Unit, the MO HealthNet Managed Care Plans, Missouri Medicaid Audit and Compliance (MMAC) and the MO HealthNet team! MHD will cover documentation, billing practices, provider resources, and more. There will be 60 seats available for this event.
At our Nursing Facility Workshop held in August, 100% of the providers who completed the evaluation stated all presenters were knowledgeable on the subject matter, were well organized and easy to follow, and the workshop was rated Excellent overall.
Watch MO HealthNet News for more information and a registration link in the coming weeks! Until then, continue to refer to the Provider Information page, the Education & Training page and the Behavioral Health Services page for resources and information. Also, join a live webinar by registering on our Provider Training Calendar.
MO HealthNet Provider Trainings
MHD Education and Training provides virtual and in-person training to MO HealthNet providers and partners. We offer training on navigating provider resources, proper billing methods, procedures for claim filing via eMOMED, and other requested topics.
View the calendar to find an upcoming training and register.
A new training will be added for Rural Health Clinics before the end of the year!
For information regarding training for the Managed Care Health Plans, visit their site directly:
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New Interprofessional Telehealth Training Program
The Missouri Telehealth Network is proud to announce a new Interprofessional Telehealth Training Program (ITTP). These learning modules guide professionals through educational trainings to equip them with a better understanding of telehealth capabilities. By enhancing access to high-quality healthcare through telehealth services, professionals can apply integrative, collaborative care models—improving communication, equity, and safety in healthcare systems across Missouri.
The Interprofessional Telehealth Training Program is an asynchronous, self-paced telehealth training for all students, as well as professionals with decades of experience. This training is free for all and offers accredited continuing education credits for some. There are five modules that take approximately 2-2.5 hours to complete. Please share with anyone looking for basic telehealth training: Interprofessional Telehealth Training Program - Missouri Telehealth Network. If you have any questions or concerns, please contact Rachel Mutrux at mutruxe@health.missouri.edu.
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Show-Me ECHO’s New Cardiovascular ECHO
Each year, heart disease accounts for more than 15,000 deaths in Missouri making it the leading cause of death in the state[1]. The terms “heart disease” or “cardiovascular disease” include many heart conditions. When coronary arteries have excess plaque buildup, they rupture or cause blood clots that block arteries. This often leads to heart attack, stroke, and/or other healthcare issues. Risk factors for cardiovascular disease include obesity, physical inactivity, high blood pressure, diabetes, high cholesterol, diet, smoking, and alcohol consumption. Among rural residents, the prevalence of cardiovascular disease risk factors is higher than that among urban residents.[2]
Additionally, cardiovascular disease presents a tremendous economic burden—approximately $407.3 billion was spent on cardiovascular disease for the 2018-2019 fiscal year[3]. That’s 12% of ALL U.S. health expenditures!
Although there are many initiatives to help address this serious issue, Show-Me ECHO’s new Cardiovascular ECHO puts together a team of experts to disseminate knowledge and best practices for screening, early detection, as well as treatment options. The Cardiovascular ECHO is an integral part of decreasing cardiovascular disease and related health issues in our state.
New EMS ECHO Alert
Prehospital clinicians, Emergency Medical Technicians (EMTs), Paramedics, Critical Care/Flight and Specialty Transport clinicians, Ambulance services, Physician Medical Directors, EMS Educators, and other professionals are encouraged to join. Participants will join the expert team in case-based learning via videoconferencing. Together, participants will:
- Identify knowledge gaps in their prehospital setting.
- Apply evidence-based treatments and best practices in the prehospital setting.
- Implement a case-based learning culture for continuous quality improvement.
Register for the EMS ECHO online.
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MO HealthNet Coverage Reminders
Annual Renewals
Please remind patients with MO HealthNet coverage, that they will need to complete an annual renewal each year. If they are not sure when this is due, they can create an account in the FSD benefit portal to check. Participants can review Renewing Your MO HealthNet Coverage for more information.
Providers may also use the Participant Annual Review Date function in eMOMED to determine when a participant’s annual review will be processed. For step-by-step instructions on this process, review the MO HealthNet Provider Overview Guide.
Premium Payments
If you have patients with MO HealthNet coverage through CHIP, the Spend Down Program, or the Ticket to Work Program, please remind them they will need to make a premium payment each month to continue their coverage.
Participants can make their premium payments through mymohealthportal.com, by automatic withdrawal, or by sending medical bills, checks, or money orders by mail. To learn more, visit MO HealthNet Premium Payment FAQs.
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MMAC's Provider Communications Portal is Live
The Missouri Medicaid Audit & Compliance (MMAC) Unit created a new Provider Communications Portal. This Portal will be a secure, efficient method for providers and MMAC to exchange information and records. The new portal provides a ‘One-Stop-Shop’, which will allow providers to:
- Update and maintain contact information, allowing for multiple contacts
- Submit forms and supporting documentation for loss or destruction of records
- Submit any required quarterly/annual reports and audits
- Submit forms and questions
- Submit anonymous complaints or fraud referrals
- Choose to receive targeted emails for specific provider types and retain the communication in the portal
- Receive (SMS) text messages
- Securely upload documents electronically versus U.S. mail or attachments to emails
- Research Frequently Asked Questions
The new Portal will allow the MMAC team to send the providers emails and/or text messages advising that they have important program information requiring their attention.
In addition, new capabilities include courtesy reminders, such as when the due date for their five-year revalidation is approaching or when a required quarterly or annual report is due.
Providers can register for the MMAC portal online.
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Proper Drug Billing Resource
The MO HealthNet Pharmacy Program is excited to introduce a new training course on Proper Drug Billing. This convenient training, which can be completed in less than 15 minutes, covers National Drug Codes, how to determine and calculate what quantity to bill, who should bill for white and brown bagged medications, and more. It will serve as a handy resource, as it includes helpful links and contact information.
For additional information, contact MHD.PharmacyAdmin@dss.mo.gov and visit our Pharmacy Program page.
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Dental Program Amendment
MHD received approval from Centers for Medicare & Medicaid Services (CMS) for the Dental Program State Plan Amendment to include coverage of periodic oral evaluations (CDT code D0120) for adults age 21 and older. Effective July 1, 2024 dental providers can provide and receive reimbursement for this service two (2) times per calendar year, per participant. Prior to July 1, 2024 this service was only available for participants that are age 20 and under, blind, pregnant, or residing in a nursing facility. Please refer to Bulletin 47-18 for more information.
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Change in Ophthalmology Rates
Pending CMS approval, effective for dates of service on or after July 1, 2024, MHD will increase the Fee-For-Service maximum allowable amount for services performed by Ophthalmologists to 85% of the 2024 Medicare rate found on the Missouri Locality 01 fee schedule.
Please refer to Bulletin 47-14 for more information.
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Subscribe to MO HealthNet News to stay up to date on MHD policies, rate changes, and more.
On MO HealthNet News, you can filter by program or type of update, such as a bulletin, hot tip, or newsletter. You can also view all the Provider Newsletters on the news webpage.
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