DSS Manuals – DSS Manuals Site
Instructions - Request for Participant MO HealthNet Reimbursement (IM-64) When to use this form: For a participant to request reimbursement from MO HealthNet Division (MHD) for incorrectly denied paid medical expenses. This should only be used when retroactive coverage is authorized as part of resolving an incorrect action on behalf of the agency. ................
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