MMAC Provider Enrollment

Turn Your Clinical Work Into Billable Revenue

Independent pharmacies in Missouri can bill Missouri Medicaid for pharmacist clinical services through Medication Therapy Management (MTM). Most pharmacies are eligible, but very few know how to properly enroll, document, and bill.

Our programs can help your pharmacist(s) become a Missouri Medicaid Provider that allows pharmacies to successfully bill MTM services with step-by-step guidance.

What These Programs Do

We help your pharmacy unlock new revenue from services you are already providing.

Our training and support show your team how to:

• Obtain Missouri Medicaid Provider Status
• Identify patients who qualify for MTM billing
• Document MTM encounters correctly
• Submit valid Medicaid claims
• Avoid common billing mistakes and audit issues
• Review payments and reconcile claims

We also provide real patient case examples to help your pharmacists confidently submit their first claims.

Why Pharmacies Are Implementing This

Independent pharmacies are under significant pressure to reduce reimbursement. MTM billing enables pharmacists to generate clinical service revenue rather than relying solely on prescription margins.

Many pharmacies are missing this opportunity simply because they do not know how to set it up correctly.

What We Provide

Our programs include:

Medicaid Provider Status application guidance
MTM documentation templates
Workflow integration for your pharmacy
Staff training and onboarding
Weekly support meetings
Claim submission guidance
Audit-safe documentation training

Program Investment

$500 One-Time Enrollment Fee (This course)

This is for clients who currently are not established as a Missouri Medicaid Provider as a pharmacist.  You must register for the MMAC Provider Enrollment course if this is needed.

Includes:

• Reviewing current status of all pre-requisite requirements to become a provider
• Assisting in completing necessary application(s) for pre-requisite requirements
• Assisting in completing necessary application for Missouri Medicaid Provider
• Assisting in any additional requests from MMAC for Provider status throughout application

$750 One-Time Setup Fee (separate course than this one)

This is for clients who currently are established as a Missouri Medicaid Provider as a pharmacist.  To receive the bulk of the training for this program, you must register for the Missouri Medicaid Provider MTM Billing course.  This course covers the documentation, case review, case submission and reconciliation and overall program training for staff within your workflow.

Includes:

• Documentation templates
• Pharmacy workflow review & planning
• Initial staff training for proper workflow
• Initial claims submissions for initial documented cases
• Claims reconciliation for submitted documented cases
• Claims corrections for submitted & denied cases

$100 Monthly Training & Support beyond initial 3 months

• Maximum 3 additional months (most pharmacies benefit from 3-6 months)
• Includes ongoing support, training, claim review, and claim reconciliation.
• Will consist of biweekly 15 minute meetings during desired months

Time Commitment

Typical pharmacy staff time:

• Potential need for CE Course to gain pre-requisite needs (MTS Licensure)
• Potential need for MTS application approval through MO BoP
• 15–30 minute support meeting for application review
• 30–45 minute support meeting for application completion
• 6–12 weeks from time of application submission to provider approval

All training is provided remotely via online training platform alongside Zoom or other web-based meetings.

Program Timeline

Most pharmacies obtain Missouri Medicaid Provider Status in 6–12 weeks if prerequisites are already in place.

Once approved, pharmacies can begin billing MTM services immediately.  This is where the next course comes into play, once Provider Status is approved.