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Missouri Medicaid
MO HealthNet enrollment, active and paid
A MO HealthNet provider number kept active, a revalidation filed before its due date, and payments that never pause.
Missouri Medicaid, MO HealthNet, is enrolled through Missouri Medicaid Audit and Compliance (MMAC), which processes new, reenrolling and revalidating providers under state regulations 13 CSR 65 2 and 13 CSR 70 3.020. Its new provider and revalidation pages, with the fee and fingerprint rules, are the sources below.
Revalidation cycle
Every active MO HealthNet provider revalidates at least every five years; revalidation means no break in active status, reenrollment means there was one. MMAC, New Providers
Due dates
Since January 7, 2019 providers check their revalidation due date online and file with supporting documents to avoid an interruption in payments. MMAC, Revalidating Providers
Application fee
$750 for new and revalidating institutional providers, collected since July 1, 2015; physicians, dentists and individual practitioners pay none. MMAC, Application Fee
Fee exemptions
A fee paid to Medicare or another state Medicaid within two years exempts the provider; a CMS hardship waiver is refunded after the fee is paid. MMAC, Application Fee
Fingerprints
High risk providers submit two sets of fingerprints for every owner at five percent or more, checked by the FBI and the Missouri State Highway Patrol. MMAC, Fingerprint Based Criminal History Checks
Fingerprint exemption
Owners fingerprinted for Medicare or another state Medicaid in the last two years do not repeat it for Missouri. MMAC, Fingerprint Based Criminal History Checks
What we see in practice
45 to 90 days from submission to an active Medicaid ID.
In the official words
Revalidation means there is no break in active status.
Missouri began collecting application fees July 1, 2015.
Missouri separates revalidation from reenrollment
MMAC processes applications from new, reenrolling and revalidating providers under 13 CSR 65 2 and 13 CSR 70 3.020. MMAC, New Providers The distinction matters for payment. A reenrolling provider was active once but is inactive when the application arrives; revalidation means there has been no break in active status. MMAC, New Providers MMAC, New Providers Every active MO HealthNet provider must revalidate at least every five years to stay a MO HealthNet provider, which is also the federal floor. MMAC, New Providers MMAC, Revalidating Providers 42 CFR 455.414
Since January 7, 2019, providers and their authorized representatives have been able to look up their revalidation due dates online, and MMAC asks them to file the revalidation application with any supporting documentation before that date to avoid any interruption in payments. MMAC, Revalidating Providers MMAC, Revalidating Providers MMAC, Revalidating Providers A separate Revalidations Unit handles those files. MMAC, Revalidating Providers
How enrollment works, step by step
- Check whether the provider type can enroll electronically. MMAC says select provider types can, and those that cannot request an application package by email. MMAC, New Providers MMAC, New Providers
- Pay the fee if the provider is institutional. The fee is $750 for new and revalidating institutional providers; physicians, dentists and other individual practitioners are exempt. MMAC, Application Fee MMAC, Application Fee It is paid through the state's vendor by card or electronic check, with a convenience fee, or by cashier's check or money order; cash and personal or business checks are refused. MMAC, Application Fee MMAC, Application Fee MMAC, Application Fee
- Attach proof of payment. An institutional application is not processed until proof the fee was paid is included. MMAC, Application Fee A fee paid to Medicare or another state Medicaid within the last two years counts instead. MMAC, Application Fee
- Fingerprint the owners if the provider type is high risk. Two sets of fingerprints go in for every person with five percent or more direct or indirect ownership, through the state's electronic vendor, and are checked by the FBI and the Missouri State Highway Patrol. MMAC, Fingerprint Based Criminal History Checks MMAC, Fingerprint Based Criminal History Checks MMAC, Fingerprint Based Criminal History Checks MMAC, Fingerprint Based Criminal History Checks MMAC staff then review the records to confirm the owners and managers are eligible. MMAC, Fingerprint Based Criminal History Checks
- Ask for a hardship waiver only after paying. A CMS hardship waiver can be requested, but the fee must be submitted before MMAC processes the application, and is refunded if CMS approves. MMAC, Application Fee MMAC, Application Fee
Missouri has collected the fee since July 1, 2015, MMAC, Application Fee and the fingerprint procedure applies to new and revalidating providers alike. MMAC, Fingerprint Based Criminal History Checks With those steps in front of a decision, our planning figure for a new Missouri provider is 45 to 90 days from submission to an active Medicaid ID.
What the two year rules are worth
Two exemptions reward recent Medicare or other state work. A provider that paid the application fee to Medicare or another state Medicaid within two years of the Missouri submission date is exempt from paying it again. MMAC, Application Fee And an owner who submitted fingerprints to Medicare or another state Medicaid in the last two years does not submit them for the Missouri application. MMAC, Fingerprint Based Criminal History Checks
Both depend on dates and proof, which is why a multistate group keeps its Medicare enrollment receipts and fingerprint confirmations with the file.
Where Missouri enrollments lose money
The expensive lapse is a revalidation that slips past its due date, because the provider then comes back as a reenrollment, with a break in active status rather than a continuous one. MMAC, New Providers MMAC, New Providers MMAC's own wording is that the revalidation and its documents are filed to avoid any interruption in payments. MMAC, Revalidating Providers
The slow lapse is an unprocessed application. An institutional file without proof of the fee waits, and a hardship waiver does not change that order: fee first, refund later. MMAC, Application Fee MMAC, Application Fee A high risk provider whose owners have not been fingerprinted waits on the FBI and Highway Patrol results before eligibility is confirmed. MMAC, Fingerprint Based Criminal History Checks
Check where you stand before you submit
WeBill Health runs Revenue Velocity Credentialing with 24/7 CAQH and PECOS lifecycle monitoring, so revalidation dates and affiliation gaps are caught before they become suspended claims. Every file gets Human Expert Review from a credentialing specialist before it goes to Missouri Medicaid Audit and Compliance.
Revenue Velocity Credentialing
WeBill Health manages the full payer enrollment lifecycle, so your revenue cycle starts the moment your practice does.
Up to 40%
less payer enrollment lag against the industry baseline
24/7
CAQH and PECOS lifecycle monitoring
Review your enrollment status with us
The Revenue Defense Audit is a free, forensic review of your claims and A/R by the team that would work your account, including providers whose MO HealthNet revalidation is coming due.
Want a quick read first? Check my Revenue Defense Score for the credentialing and denial exposure in your specialty.
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