23 Miss. Code. R. 202-1.2 - Provider Enrollment
Hospital providers, including psychiatric hospitals and swing bed providers applying for enrollment into the Medicaid program must satisfy all requirements set forth in Part 200, Chapter 4, Rule 4.8 in addition to the following provider type specific requirements:
A. National Provider Identifier (NPI),
verification from National Plan and Provider Enumeration System
(NPPES).
B. Written confirmation
from the IRS confirming your tax identification number and legal business
name.
C. CLIA certificate and
completed certification form.
D.
Licensed freestanding psychiatric hospitals must submit Joint Commission on
Accreditation of Health Care Organization (JCAHO).
E. Copy of current Medicare certification or
Tie-In Notice. EOMB is not acceptable.
F. Out of state facility: Copy of outstanding
claims, if applicable.
G. Copy of
hospital license
1. Out-of-state facility:
Copy of license/certification in effect during the claims period for which they
are billing.
2. In-state facility:
A copy of letter from the Mississippi State Department of Health is
acceptable.
3. Hospital undergoing
a Change of Ownership (CHOW): License in effect for the new owner.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.