23 Miss. Code. R. 202-3.2 - Certification of Providers/ Provider Enrollment
A. The
Division of Medicaid requires any hospital certified for participation in the
Medicare swing bed program who wants to participate in the Medicaid program to
become a provider. A separate provider number from the hospital is required for
the swing bed.
B. Hospital
providers, including 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 submitting the following provider type specific
requirements:
1. National Provider Identifier
(NPI), verification from National Plan and Provider Enumeration System
(NPPES).
2. Written confirmation
from the IRS confirming the provider's tax identification number and legal
business name.
3. CLIA certificate
and submit the completed certification form.
4. Joint Commission on Accreditation of
Health Care Organization (JCAHO) for licensed hospitals.
5. Copy of current Medicare certification or
Tie-In Notice. Explanation of Medicare Benefits (EOMB) is not
acceptable.
6. Copy of outstanding
claims, if applicable, for out-of state facility.
7. Copy of Hospital license:
a.Copy of license/certification, in effect
during the claims period for which they are billing for out-of state
facility.
b. In-state facility: A
copy of letter from the Mississippi State Department of Health is acceptable
for in-state facility.
c. License
in effect for the new owner for Hospital undergoing a Change of Ownership
(CHOW).
Notes
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.