Meet Your Payors
Your payor mix should be based on your patient’s needs. From Managed Care to Fee-For-Service, gain clarity before credentialing so you know which payors with which to enroll.
TIPS & GUIDANCE
Session Recording
This session will give you a better understanding of which credentialing applications you should complete based on your patient's demographics.
Resources
Verifying Patient Eligibility
Get step-by-step guidance on verifying patient eligibility and plan enrollment – an important part of determining which plans you should partner with to maintain practice profitability.
Webinars
Dental Provider Credentialing, Policy, and Claims Series
Learn more about the processes and benefits of working with MO HealthNet and Managed Care Plans.
Here for You at Every Step
Schedule A Session
Medicaid can seem overwhelming, but we're here to help. Your Dental Medicaid Facilitator, Lori Reed, is here to talk about your challenges or questions.
Schedule a one-on-one session below or email Lori at lreed@oralhealthmissouri.org.
Your Questions Answered
Frequently Asked Questions
How Do Providers Know Which Health Plan Participants Have?
Participants should have an ID card for the health plan in which they are enrolled. Providers should always use the eMOMED portal to verify eligibility.
When a Provider Enrolls with a Managed Care Plan, Do They Have to See That Plan's PPO Members As Well?
No, the Managed Care plans are not umbrella plans. Enrolling with a Managed Care plan allows you to be reimbursed for dental Medicaid services provided to participants with coverage under that plan through MO Medicaid.
How Can Providers Determine Which Services Require Prior Authorization with Each Managed Care Plan?
Managed Care plans should be contacted directly for this information. Contact information for each plan is provided on the slides above and more information can be found on the Submitting Claims blog post resource.