MedicaidAdministrativeMedium impact
Third Party Liability Information for Providers
Missouri Medicaid (MO HealthNet)·MO·Provider Notice
Effective date
Dec 29, 2022
We identified it
Jun 20, 2026
Summary
Missouri HealthNet has issued updated guidance on Third Party Liability (TPL) requirements, clarifying that MO HealthNet is the payer of last resort and providers must always bill other insurance (including Medicare, employer plans, etc.) first before billing Medicaid. The policy provides specific procedures for verifying TPL information and reporting other payer payments through eMOMED or managed care plans.
Action Required
Immediately: Billing team must verify all MO HealthNet participants have TPL information checked through eMOMED or IVR system at (573) 751-2896 before billing. Always bill primary insurance first, then report EOB/RA information in eMOMED under 'Other Payer' section for Fee-for-Service participants or directly to managed care plans. Report missing or incorrect TPL information using Insurance Resource Report (TPL-4) form to TPL.Database@dss.mo.gov. Failure to follow TPL requirements may result in claim denials.