MedicaidAdministrativeHigh impact
Dental Program
Missouri Medicaid (MO HealthNet)·MO · Dentistry·Provider Notice
Effective date
Jul 8, 2022
We identified it
Jun 20, 2026
Summary
When submitting paper ADA Dental Claim forms for MO HealthNet, providers must complete Field 23 with the participant's MO HealthNet number exactly as shown on their ID card. Claims will be denied if Field 23 contains anything other than the participant's DCN or is left blank.
Action Required
Immediately: Billing team must ensure Field 23 on all paper ADA Dental Claim forms contains the participant's MO HealthNet number exactly as shown on the participant's ID card. Train staff to verify the DCN from the patient's ID card before form submission. Claims with incorrect or blank Field 23 information will be denied.