Missouri Certification of Being Under Physician's Care

State:
Multi-State
Control #:
US-00431BG
Format:
Word; 
Rich Text
Instant download

Description

This certification, or Doctor's excuse, can be used to notify either the patient's school or employer.

How to fill out Certification Of Being Under Physician's Care?

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FAQ

The Physician Certification Form is posted on the Department's website at . The following information is required: qualifying patient information, physician information, qualifying medical condition, physician attestation and agreement, and physician signature and date.

Providers may contact the Interactive Active Voice Response System (IVR) telephone number for MO HealthNet program assistance at 573/751-2896.

The Family Support Division within the Department of Social Services determines participant eligibility for the MO HealthNet programs.

Inquiries about Missouri Medicaid should be directed to the contact center by phone at 800-348-6627. For case- or member-specific inquiries, please use secure messaging or contact us at 800-348-6627.

Pharmacy Help Desk, Drug Prior Authorization, Diabetic Supply Prior Authorization, Durable Medical Equipment (DME) Smart PA's, and Med Solution precertification Process: 1-800-392-8030.

If you are approved for help, you will have healthcare coverage through Missouri Medicaid (MO HealthNet). This healthcare coverage is different than Medicare and it can help with benefits not normally covered through that program, like nursing home care and personal care services.

Missouri Medicaid (MO HealthNet) Home State Health: 855-694-4663.

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Missouri Certification of Being Under Physician's Care