MO · guidance
MO HealthNet Hospice Provider Manual § 4.3
Resubmission of Claims
Any line item on a claim that resulted in a zero (0) payment can be resubmitted if it denied due to a correctable error. The error that caused the claim to deny must be corrected before resubmitting the claim. The provider may resubmit electronically or on a UB-04 claim form. A claim that denied appropriately for failing timely filing should not be resubmitted.
If a line item on a claim paid but the payment was incorrect, do not resubmit that line item. For instance, if the provider billed 21 units of service but should have billed 31 and there is nothing else wrong with the claim, it will pay. That claim cannot be resubmitted because it will deny as a duplicate. The provider must submit a ‘replacement’ claim via eMOMED to correct that payment. A replacement claim will recoup the incorrect payment received and replace that claim with a corrected one through real-time adjudication so that proper payment can be received. Refer to the General Sections Manual for more information about the adjustment request process.
Provenance
- Source
- dss.mo.gov
- Retrieved
- 2026-10-01
- Edition
- mhd-hospice-2026-04-13
- Content hash
30711f2286167b19809a55d067f6a91a2f389dc412f13de60ba239d30dfcaaba
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