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News Updates

Dental Medicaid: Making Your Billing as Effective as Possible

by J​ohn Dane, DDS

As a MO HealthNet dental provider, you are special: You’re part of a dedicated team that provides dental service to patients who can’t access care any other way. Those of us at the MO HealthNet Division (MHD) want to help make treating our participants a good experience for everyone involved—including our providers who make these dental services happen. Providers are sometimes frustrated by Medicaid billing, but this is something that both the providers and MHD staff can work on together to remedy.

First, be aware that filing paper claims is the slowest route of claims processing. Using the EMOMED web portal to file claims electronically is much faster. I understand that some providers’ remittances have been received within 14 days of filing via EMOMED. If you have an Electronic Dental Record System you can file electronically through that system as well. Go online to register to use EMOMED, or contact the help desk at 573-635-3559 for information.

MHD dental claims are processed a bit differently from your average dental insurance claim. Medicaid must follow federal system requirements, and there are some differences in software and equipment.

TIPS TO HELP YOUR CLAIMS PROCESS MORE SMOOTHLY

Accuracy is important! Use the most current and correct CDT codes, quantities and other information on your claim to avoid delays due to manual processing. Manual processing is required when non-covered codes or invalid quantities are billed. For example, D0230 is for an additional Periapical x-ray. MO HealthNet covers only four of these films per date of service. If you bill more than four, this will cause the claim to be reviewed manually.

Take time to review our Dental Billing Tips. Avoiding these billing errors up front will help reduce your claim processing time. Make sure your billing staff is up to date on the latest changes in Medicaid. Provider Bulletins are published as changes happen and supersede the latest Provider Manual (a new one will be published this spring). Bulletins are available online. To ensure you get notification of these, we suggest you sign up for MO HealthNet News to receive email notice about new provider Hot Tips, bulletins, manual updates and other alerts. Register at dss.mo.gov/mhd/providers.

MHD offers regular Webinar Trainings on proper billing for you and your staff and it’s free! Check the schedule and sign up. If the pre-set schedule doesn’t work for you or your staff, the Provider Education staff also can provide individual webinars so providers and/or billing personnel can speak directly to an Education Specialist. Call 573- 751-6963 and ask to speak to an Education Specialist to set up your appointment.

In-person Provider Workshops also are held regularly in Jefferson City. Check the webpage for the schedule. Finally, if you just have a question, you can always email ask.mhd@dss.mo.gov and we will provide a prompt response.

Send questions/comments for Dr. Dane to john.dane@dhss.mo.gov or call 573-526-3838.

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