Claims

MCO enrollee complaint policy and procedures

Providers are required to submit electronic or paper claims to MPC for reimbursement within 180 days from the date of service. For a claim on a CMS 1500 claim form, 180 days is counted from the day that the service was performed. For a claim on a UB 04 claim form, 180 days is counted from the date of discharge for the hospital or nursing home stay. Claims that are not initially received within 180 days of the date of service may be denied for payment. Please mail medical claims to:

Claims
P.O. Box 5080
Farmington, MO 63640-5080

We prefer to receive electronic claims via a MPC-approved Electronic Data Interchange (EDI) vendor. Please contact your Provider Relations representative for further information on electronic claims or for a list of approved EDI vendors. After MPC has adjudicated a claim, you will receive a Remittance Advice with the reimbursement, which will provide details about the submitted claim and its status.