23 Miss. Code. R. 218-1.1 - Provider Enrollment Requirements
A. State-licensed
audiologists and physicians must render services under their license as an
audiologist or physician.
B. All
providers of Medicaid services must comply with the requirements for enrollment
as outlined in Part 200, Chapter 4, Rule 4.8. Physicians must satisfy the
additional provider type requirements outlined in Part 203, Chapter 1, Rule
1.1. Audiologist and hearing aid dealers must satisfy the additional provider
type requirements listed below:
1. National
Provider Identifier (NPI), verification from National Plan and Provider
Enumeration System (NPPES),
2. Copy
of current license in the state in which the individual furnishes the
services,
3. Verification of having
met the following requirements:
a) A master's
or doctoral degree in audiology,
b)
Has received a license from a state that requires the following conditions be
met for licensure:
1) Has a Certificate of
Clinical Competence in Audiology granted by the American
Speech-Language-Hearing Association for licensure, or
2) Has successfully completed a minimum of
three hundred fifty (350) clock-hours of supervised clinical practicum, or is
in the process of accumulating that supervised clinical experience under the
supervision of a qualified master or doctor-level audiologist; performed at
least nine (9) months of full-time audiology services under the supervision of
a qualified master or doctoral-level audiologist after obtaining a master's or
doctoral degree in audiology, or a related field; and successfully completed a
national examination in audiology approved by the Secretary.
c) In the case of an individual
who furnishes audiology services in a State that does not license audiologists,
or an individual exempted from State licensure based on practice in a specific
institution or setting, the individual must meet one (1) of the conditions in
Part 218, Chapter 1, Rule 1.1.3(b).
4. Verification of a social security number
using a social security card, driver's license if it notes the social security
number, military ID or a notarized statement signed by the provider noting the
social security number, for individual providers. The name noted on
verification must match the name noted on the W-9.
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No prior version found.