We recognize that, at times, the administrative requirements of managing your patients' health care can be complex. The Provider Manual is a source of answers to questions you may have about health plan coverage procedures, policies and other facts related to your provision of health care services to our members.
Please Note:Effective October 1, 2009, Missouri HealthNet Division (MHD) is carving out coverage for all medications and pharmaceuticals administered on an outpatient basis. These services should be billed to the State of Missouri's MO HealthNet Fee-For-Service program, using the product’s NDC on the claim form. The Pharmacy section (Section 6) of the Harmony Health Plan of Missouri's Provider Manual has been removed. Please contact the MHD Pharmacy Help-Desk at 1-800-392-8030 for more information or to answer any questions.
Preface
Table of Contents
Section 1: All About WellCare
Section 2: Provider Responsibilities
Section 3: Member Services
Section 4: Benefits and Limitations
Section 5: Utilization Management
Section 7: Claims
Section 8: Appeals and Grievances
Section 9: Credentialing
Section 10: Quality Improvement
Section 11: Medical Records
Section 12: Case Management
Forms
Provider Education MaterialsQuick Reference Guide
