All billers – please call or email MC+ Contract Compliance with MoHealthnet if you are having problems getting immunizations paid by Healthy Blue. If you have done your due diligence and talked to the managed care company and are still not getting paid correctly, PLEASE FILE A COMPLAINT. Either by phone 573-526-4274 or email: mhd.mccommunications@dss.mo.gov The more complaints to the state oversite, the more leverage they have to get the managed care company in gear and paying as they are supposed to.
I filed a complaint and within 2 days Healthy Blue contacted me and sent a spreadsheet with all my claims that were reprocessed that day. Healthy Blue is also supposed to be reprocessing the immunization claims not paid correctly every two weeks. Healthy Blue knows they have a problem but are dragging their feet in fixing it and paying these claims. They do not want a bunch of complaints to the state because it will look bad next time the contracts are up for bid. File complaints – it should get the problem fixed quicker.