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How Do I Submit My Dental Medicaid Claims for Payment?

Jul 10, 2023

Coding and billing is the final piece of growing practice profitability with dental Medicaid.

Remember, the practice location as well as the performing provider have to be credentialed with the care plan in which the patient is enrolled.

This allows you to submit the claim to the appropriate payor for reimbursement.   

Let’s start with the steps for submitting claims for Fee-For-Service or Traditional Medicaid.

Fee-for-Service care is always billed through MO HealthNet. This care plan typically covers adults, adults with disabilities, and senior populations.

Once logged in to the eMOMed portal, Choose ‘Claim Management’ to begin your claim submission. Next select ‘New Claim’ and then ‘Dental’. See a video walkthrough here.

  • Start by populating the Participant Information fields – and remember, these fields must match the patient’s MO HealthNet ID Card exactly for their claim to be accepted and processed.

  • The Patient Account Number is based on your practice’s records management system. It is an optional field.

  • Next enter the NPI of the performing provider and the place of service. The field for ICD10 code is also optional.

  • Once complete, you can save your Claim Header. Now you’re ready to add procedure details.

  • Under the Dental Details section, enter the Date of Service, the performing provider’s NPI, not the group’s, and the procedure code.

  • Now under ‘billing charges’ you should enter what your practice charges for this procedure, not what you know to be the current reimbursement.
    • If MO HealthNet later increases their reimbursement for this procedure, your practice can be retroactively paid for the difference.
  • Then enter the Units, Diagnostics Code and Place of Service. Select Save.

  • Continue adding Procedure Details line by line for this Claim until complete.

  • Once complete, you can submit your claim.

Providers are encouraged to attend one of the dental provider billing webinars found on the Provider Training Calendar. These 2-hour interactive webinars will walk you through the entire eMOMED claims process.


When You're Billing the Managed Care Plans, use their unique portal for submitting claims.  

Select one of the Managed Care Plans below for details on how to submit claims in their portals:

  1. HealthyBlue – DentaQuest
  2. Home State Health – Envolve
  3. United Healthcare

 Once you’ve submitted your claims, you can check status within each plan’s portal.

If you have questions about any of your submitted claims, you can follow up by email or through the chat or email features within the respective plan’s portal:

  1. MO HealthNet – email through eMOMed or call (573) 751-2896
  2. HealthyBlue – email bryant@dentaquest.com or call 800-233-1468
  3. Home State Health – email ProviderRelations@envolvehealth.com or call 855-434-9240
  4. United Healthcare – email Missouri_PR_Team@uhc.com or call 800-822-5353

 

Still Unsure About Submitting Your Medicaid Claims?
Check out some additional support for Managed Care Dental Providers as well as our education page.

Need More?
Your Medicaid Mentor – Jessica Emmerich, is here to offer you support. Email, call, or text her at 573-536-2474.