23 Miss. Code. R. 220-1.1

Current through October 18, 2024

Rule 23-220-1.1 - Provider Enrollment Requirements

A. Radiology providers must satisfy all requirements set forth in Part 200, Chapter 4, Rule 4.8 in addition to 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 name, and

3. Clinical Laboratory Improvement Amendments (CLIA) certificate and completed Certification form, if applicable.

B. Independent Diagnostic Testing Facility (IDTF) providers can only be enrolled for submission of crossover claims.

1. IDTF providers cannot be enrolled for submission of straight Medicaid claims.

2. A copy of the Medicare certification from the Medicare Intermediary is required.

3. The Explanation of Medicare Benefits (EOMB) is not acceptable.

23 Miss. Code. R. 220-1.1

Miss. Code Ann. § 43-13-121; 42 CFR § 455, Subpart E.