Adult Brain Injury Program Providers
As a licensed/certified provider, you are essential to the health and well being of Missourians with special health care needs.
Provider Information
- ABI Service Coordinator Map
- ABI Provider Information Brochure
- ABI Program Provider Manual
- ABI Program Prior Authorization
- ABI Treatment Plan
- ABI Program Prior Authorization Modification & Monthly Progress Report Form
The following billing forms should be utilized:
If you are interested in becoming a provider, contact the SHCN Central Office by phone or in writing to request an application packet or refer to the “New Provider Enrollment, Re-Enrollment and Provider Address Change Information” section below.
New Provider Enrollment, Re-Enrollment and Provider Address Change Information
Providers must review and complete the Participation Agreement and Provider Application for new enrollment, re-enrollment or when there is a change in their payment mailing address. Additionally, registration is required at MissouriBUYS, powered by MOVERS. In the event of an address change, providers must also update their information in MissouriBUYS, powered by MOVERS. Submit the completed forms via email or mail.
- Adult Brain Injury Participation Agreement (effective 07/01/2022-06/30/2025)
- Adult Brain Injury Participation Agreement (effective 07/01/2025-06/30/2028)
- Provider Application (CC-35)
- MissouriBUYS, powered by MOVERS
Resources
- Missouri Brain Injury Advisory Council
- Missouri Protection and Advocacy
- Brain Injury Association of Missouri
- Brain Injury Association of Kansas and Greater Kansas City
- National Institute of Neurological Disorders and Stroke