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Electronic Submission of MO HealthNet Claims and Electronic Remittance Advices - Mo. Code Regs. Ann. tit. 13, § 70-3.160

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All claims submitted under Missouri’s Medicaid program must be submitted to the agency electronically.  Each Medicaid provider must obtain an electronic identifier and is responsible for the accuracy of the data submitted electronically.  All Medicaid providers must also maintain paper copies of all records at the location the services have been rendered for a period of five years.  The medical record must document the medical necessity of the service provided, and must include the signature of each Medicaid participant.  If a provider fails to keep accurate records, he or she may be subject to recoupment or disallowance of payments.  The electronic system must be secure to ensure that all beneficiary information is protected from unauthorized access.  Any person who attempts or submits a false claim, statement or misrepresents a material fact may be subject to civil or criminal penalties.

Current as of June 2015