Medical billing services in Missouri
Billing, coding, credentialing and A/R follow-up for providers in Missouri.
Billing in Missouri: what is different
MO HealthNet managed care plans serve most Medicaid members statewide.
Key payers and contractors in Missouri
- Medicare Part A/B
- WPS Government Health Administrators, Jurisdiction J5Portal: WPS GHA Portal
- Medicare DME
- Noridian, DME MAC Jurisdiction DDME supplier claims only · Portal: Noridian Medicare Portal (NMP)
- Medicaid
- MO HealthNetPortal: eMOMED
- Blue Cross Blue Shield
- Anthem Blue Cross and Blue Shield, and Blue KC in the Kansas City area
- Medicare Advantage
- UnitedHealthcare, Humana, Aetna, Wellcare, Blue plans and others, depending on the county
Contractor assignments and plan lists change. We confirm the current setup for your practice during onboarding.
How we work with Missouri providers
- Medicaid enrollment with the state, then credentialing with each managed care plan you need
- Medicare enrollment through PECOS and claims with WPS Government Health Administrators through the WPS GHA Portal
- Credentialing and contracting with commercial and Blue plans
- Eligibility checks that confirm each patient’s plan and assigned MCO before the visit
- Prior authorization tracking by plan
- Denial, appeal and A/R follow-up under each payer’s filing limits
Medical billing in Missouri: common questions
Do you bill MO HealthNet and its managed care plans?
Yes. We bill MO HealthNet fee-for-service claims and each Medicaid managed care plan, after confirming the patient’s assigned plan for the date of service.
Who processes Medicare claims in Missouri?
Medicare Part A and B claims in Missouri are processed by WPS Government Health Administrators (Jurisdiction J5), and we submit and track them through the WPS GHA Portal. DME supplier claims go to a different contractor, Noridian (DME MAC Jurisdiction D), through the Noridian Medicare Portal (NMP).
Can you credential new providers in Missouri?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in Missouri.
Get a free billing audit for your Missouri practice
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.