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Today I received my EOB for MO CARE and they stated the child does not have vaccine coverage. But they will pay administration fee. We dont bill administration fee for VFC. In the past all of my MO CARE clients have been paid. Has anyone else had this come up?
Yes, I have gotten 2 denials like this in the last week. I contacted Missouri Care, they resubmitted the claim & it was still denied. I was told I need to contact my Rep for assistance. I am in that process now.
Yes I got the same thing yesterday! The RA said not a covered benefit. Talked with customer service at Well Care and they told me to send a certified mail with documents that stated the child did need the immunizations! They did not resubmit the claim though. I am wondering if this has anything to do with them merging with Anthem. Never had this happen before.
Cindy I thought the same thing regarding the merge, but asked the claims department @ Missouri Care when I was on the phone with them and was told it had nothing to do with the merge. I have a call at 10:00 this morning with my Rep to hopefully get some answers. I never had gotten a denial like this until anything billed after January 23rd. It’s really weird. Thanks for mentioning you are having this issue too so I can let the Rep know it’s happening to more than just me.
Cindy & Jill,
I just got off the phone with my Missouri Care Rep. These denials are an internal error and they will be doing a sweep to reprocess these. Watch your remittances to see when these have reprocessed. Also, she told me to hold off processing any new Missouri Care claims until the issue is fixed. She said she would let me know when the problem has been resolved so I can process new claims.Can you please let us know when this is resolved? I have not processed any MOCARE claims since all of yours have been denied. But, I am sure I will have some in the near future and don’t want to process any until it’s been resolved. Thanks!
Thanks! Missouri Well Care customer service department has no idea! She did tell me that it was because of the merger. And that I needed to use an administrative code instead of my vaccine admin code. I can’t get ahold of my customer rep. I will not be submitting any claims to them until they can answer these questions.
Megan,
I was trying to find ours as well. If someone does have a number for you would you mind sharing it please.Thanks,
JillAre you calling 800-322-6027? My provider relations rep is Christa Hudson. I do have her email and direct phone number. She is really easy to deal with. Also, Whitney Keith is my community relations specialist. I also have her contact info. Not sure if these two ladies would be who you need to contact or not. What county are you in?
I found something that maybe helpful! Google search Missouri Care Provider Relations Territory Map and you should get a link to a pdf file that has all the counties and their provider relations reps with phone numbers. It’s from 2017, but it is a place to start! Mine was Ronald Caradine and he is actually still there!
Ours used to be Whitney Keith but our new one is Abby Shivers. Her contact info is: 417-572-7803 or cell 314-346-5100 or Abigail.shivers@wellcare.com
This is for SW MO (Lawrence Co) but I’m sure she can link you up if you are not in her territory.
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