MedicaidAdministrativeMedium impact
Changes to Remittance Advice
Missouri Medicaid (MO HealthNet)·MO·Provider Notice
Effective date
Apr 19, 2019
We identified it
Jun 20, 2026
Summary
MO HealthNet changed how they report submitted charges on remittance advice (835) for crossover claims to comply with HIPAA guidelines. Instead of using patient responsibility amounts from Medicare EOBs, they now report the actual line item charges submitted by providers, resulting in more contractual obligation adjustments (CO 45).
Action Required
Billing team should review remittance advice processing procedures to expect more CO 45 contractual obligation adjustments on MO HealthNet crossover claims. Update staff training on how submitted charges versus paid amounts are now reported differently on 835 remittance advice to avoid confusion during payment posting.