MedicaidAdministrativeMedium impact
Inpatient Certification Reconsideration Process
Missouri Medicaid (MO HealthNet)·MO·Provider Notice
Effective date
Oct 8, 2025
We identified it
Jun 20, 2026
Summary
Missouri HealthNet (Medicaid) has established a formal reconsideration process for denied inpatient certifications. Providers can request reconsideration within 3 working days if patient is still inpatient or 60 calendar days if discharged, with specific mailing addresses and documentation requirements.
Action Required
Immediately: Billing and authorization teams must establish workflow for inpatient certification denials from Conduent/MO HealthNet. Save contact information: (800) 766-0686 Option 0 for reconsiderations, (833) 222-7916 for other questions. Create reminder system for 3-day deadline (inpatients) or 60-day deadline (discharged patients). Add mailing addresses to quick reference: USPS - P.O. Box 105110 Jefferson City, MO 65110; FedEx/UPS - 3425 West Truman Jefferson City, MO 65109. Train staff to include all pertinent medical documentation with reconsideration requests.