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Timely Filing of Claims When Health Net is the secondary payer, we will process claims received within 180 days after the later of the date of service and the date of the physicians receipt of an Explanation of Benefits (EOB) from the primary payer.
Timely Filing Criteria - Original Submission MO HealthNet Claims: Claims from participating providers that request MO HealthNet reimbursement must be filed by the provider and received by the fiscal agent or state agency within 12 months from the date of service.
At the very latest, claims must be submitted by December 31 of the year after the year you received the service, unless timely filing was prevented by administrative operations of Government or legal incapacity, provided the claim was submitted as soon as reasonably possible.
4.1.A MO HEALTHNET CLAIMS Claims from participating providers who request MO HealthNet reimbursement must be filed by the provider and must be received by the state agency within 12 months from the date of service.
Call: Constituent Services at 800-392-2161. Please have your identification Number from your MO HealthNet card ready.
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Benefit Program Income Limits Program15 Program MO HealthNet for Expansion Adults 1 $20,030 5 $48,651 Program MO HealthNet for Families 1 $1,692 5 $4,800 Program MO HealthNet for the Aged and Disabled 1 $12,801 5 $31,093 Program MO HealthNet for the Blind 1 $15,060 5 $36,58010 more rows
Timely filing is when an insurance company put a time limit on claim submission. For example, if a insurance company has a 90-day timely filing limit that means you need to submit a claim within 90 days of the date of service.
If you are unhappy with your health plan, provider, care, or your health services, you can file a grievance by phone or in writing at any time. To file by phone, call Member Services at 833-388-1407 (TTY 711).

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