Mississippi Application Service Provider Agreement
Description
How to fill out Application Service Provider Agreement?
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FAQ
Eligible members do not directly receive money from Medicaid for health benefits. Medicaid is separate from Medicare. Total monthly income can be no more than 135 percent of the federal poverty level: $1,691 per month for an individual, or ? $2,269 per month for a couple.
Claims for covered services must be filed within 12 months from the through/ending date of service. Providers are encouraged to submit their claims as soon as possible after the dates of service.
To enroll as a Mississippi Medicaid provider, you have two submission options: Downloading the application and submitting hard copy signature pages/documents. Enrolling online and submitting the hard copy signature pages and documentation.
To be eligible for Mississippi Medicaid, you must be a resident of the state of Mississippi, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.
Mississippi Medicaid includes multiple health benefits programs administered by DOM: fee-for-service Medicaid, MississippiCAN and CHIP. The federal medical assistance percentage (FMAP) is used to calculate federal matching funds for medical service expenditures.
MississippiCAN is a Mississippi Medicaid sponsored health insurance program for eligible children and adults with low income. Our MississippiCAN plan offers comprehensive, free health coverage for eligible residents of Mississippi.
A. The Division of Medicaid covers dental expenditures, excluding orthodontia-related services, up to twenty five hundred dollars ($2,500.00) per beneficiary per state fiscal year.
State of Mississippi - Search and Services/Information For further questions, please contact Provider Services at 1-800-884-3222.