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MO HealthNet Internet Provider Training Program Presented by the Provider Education Unit MO HealthNet Division. Proper Completion of the Online Outpatient Claim. Presented by the Provider Education Unit MO HealthNet Division.
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MO HealthNet Internet Provider Training Program Presented by the Provider Education Unit MO HealthNet Division Mo HealthNet Division
Proper Completion of the Online Outpatient Claim Presented by the Provider Education Unit MO HealthNet Division Mo HealthNet Division
To file a claim go to the Internet Web site www.emomed.com and log on under the appropriate NPI and Taxonomy code, if applicable for the claim to be submitted. This will bring up the eProvider Home Page. At the top of each page is a “Help” button in the form of a question mark. You can print out field-by-field instructions. Mo HealthNet Division
Participant Information 01010101 Mo HealthNet Division
Participant Information PATIENT Mo HealthNet Division
Participant Information IMA Mo HealthNet Division
Participant Information Mo HealthNet Division
Service Information M200000000 NOTE: BOXES IN GRAY ARE NOT REQUIRED FIELDS FOR THIS CLAIM Mo HealthNet Division
Service Information 1-Emergency NOTE: BOXES IN GRAY ARE NOT REQUIRED FIELDS FOR THIS CLAIM Mo HealthNet Division
Code Details 8820 E8490 4019 Mo HealthNet Division
Code Details AJ – Payer Responsible for Co-payment NOTE: WHEN BILLING 1-EMERGENCY ADMIT TYPE A CONDITION CODE AJ MUST BE ENTERED TO EXEMPT THE PARTICIPANT FROM THE COST SHARING AMOUNT FOR THE SERVICE Mo HealthNet Division
Save Claim Header Information Mo HealthNet Division
Detail Line Information 11/15/2012 Mo HealthNet Division
Detail Line Information NOTE: WHEN BILLING A FACILITY SUPPLY CODE (0260, 0270, AND 0274) THE PROCEDURE CODE AND MODIFIERS FIELDS ARE LEFT BLANK Mo HealthNet Division
Detail Line Information 0270 Mo HealthNet Division
Detail Line Information 250.00 Mo HealthNet Division
Detail Line Information 1 NOTE: WHEN BILLING A FACILITY SUPPLY CODE (0260, 0270, AND 0274) THE DAY/UNITS FIELD SHOULD BE “1” Mo HealthNet Division
Detail Line Information Mo HealthNet Division
Detail Line Information Mo HealthNet Division
Detail Line Information Mo HealthNet Division
Detail Line Information Mo HealthNet Division
Detail Line Information 11/15/2012 Mo HealthNet Division
Detail Line Information 85025 Mo HealthNet Division
Detail Line Information 0305 Mo HealthNet Division
Detail Line Information 75.00 Mo HealthNet Division
Detail Line Information 1 Mo HealthNet Division
Detail Line Information Mo HealthNet Division
Detail Line Information 11/15/2012 Mo HealthNet Division
Detail Line Information 12002 Mo HealthNet Division
Detail Line Information NOTE: FOR REPORTING LINE THE MODIFIERS FIELDS SHOULD BE LEFT BLANK Mo HealthNet Division
Detail Line Information 0361 Mo HealthNet Division
Detail Line Information 0.00 Mo HealthNet Division
Detail Line Information 1 Mo HealthNet Division
Detail Line Information Mo HealthNet Division
Detail Line Information 11/15/2012 Mo HealthNet Division
Detail Line Information NOTE: WHEN ENTERING A FACILITY REVENUE CODE (0450, 0459, 0490, AND 0510) THE PROCEDURE CODE AND MODIFERS FIELDS ARE LEFT BLANK Mo HealthNet Division
Detail Line Information 0459 Mo HealthNet Division
Detail Line Information 400.00 Mo HealthNet Division
Detail Line Information 1 NOTE: WHEN BILLING A FACILITY REVENUE CODE (0450, 0459, 0490, AND 0510) THE DAY/UNITS FIELD SHOULD BE “1” Mo HealthNet Division
Detail Line Information Mo HealthNet Division
Other Payer Information Mo HealthNet Division
Other Payer Information Mo HealthNet Division
Other Payer Information 1 Mo HealthNet Division
Other Payer Information ABC INSURANCE CO Mo HealthNet Division
Other Payer Information 11/26/2012 Mo HealthNet Division
Other Payer Information 325.00 Mo HealthNet Division
Other Payer Information 0.00 Mo HealthNet Division