Meet Your Payors 2024 Session Recap
This session will give you a better understanding of which credentialing applications you should complete based on your patient's demographics.
Here is the Full Session Recording:
Medicaid Mini Series Session 2 - Meet Your Payors
Here are the Presentation Slides:
Need to Know:
How Do I Verify My Patient’s Eligibility for Medicaid Services?
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Frequently Asked Questions
Perhaps you have a few questions. Take a look at some that were commonly asked below. If your question isn't answered here, we're happy to help. Please email Jessica Emmerich and she will respond with the appropriate resources.
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 our blog post: How to Submit Dental Medicaid Pre-Auth Requests.
Do I Need to Verify a Participants Managed Care Plan on the Date of Service?
Yes, participants can change plans and their eligibility can change. It is the provider's responsibility to verify their plan and eligibility on the date of service. Read more about determining elibility on our blog post: How Do I Know If I'll Get Paid for Medicaid Care?
Additional Resources: