Medical billing for Missouri practices

Medical Billing Services in Missouri

MO HealthNet is not KanCare and not HealthChoice Illinois. MO HealthNet is run by the Missouri Department of Social Services. Managed-care members are billed to their plan. Fee-for-service MO HealthNet is a different submission. Kansas City and St. Louis both split members with the neighboring state. The card, not the metro, picks the program.

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What a claim follows in Missouri

MO HealthNet is not KanCare and not HealthChoice Illinois.

MO HealthNet

MO HealthNet is run by the Missouri Department of Social Services. Managed-care members are billed to their plan. Fee-for-service MO HealthNet is a different submission. Kansas City and St. Louis both split members with the neighboring state. The card, not the metro, picks the program.

WPS, Jurisdiction 5

Medicare Part A and Part B for a Missouri practice go to WPS Government Health Administrators, Jurisdiction 5, with Kansas, Iowa, and Nebraska. Illinois uses National Government Services, Jurisdiction 6. Arkansas and Oklahoma use Novitas Jurisdiction H.

Workers' compensation

Missouri is not a no-fault state. A work injury is billed to the employer's carrier under the Division of Workers' Compensation. It is not a MO HealthNet claim.

Two Missouri borders are Medicare borders. Cross into Illinois and Part B moves to National Government Services. Cross into Arkansas and it moves to Novitas. MO HealthNet enrollment does not travel with either change.

Nearby states

Missouri billing questions

What is MO HealthNet?

Missouri Medicaid. Managed-care members are billed to their plan. It is not KanCare.

Where does a Missouri Medicare claim go?

WPS Government Health Administrators, Jurisdiction 5. Illinois uses National Government Services.

Does a Missouri practice change the fee?

The fee is a percentage of net collections. The written rate follows volume, specialty, and how much of the cycle you hand over. There is no setup fee, and the agreement is month to month. The state is not a surcharge. How pricing is set.