23 Miss. Code. R. 213-4.1 - Appeals for Therapy Services
A. Reconsideration
Process - The beneficiary, therapy provider, or prescribing provider is
afforded the right to appeal a utilization review denial to the UM/QIO through
the reconsideration process set forth by the UM/QIO.
B. Administrative Appeal - Disagreement with
the UM/QIO reconsideration determination shall be appealed to Medicaid by the
beneficiary/legal representative. The beneficiary/legal representative must
submit a written request for administrative appeal within thirty (30) calendar
days of the UM/QIO reconsideration determination notice.
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