On July 1, 1997, HealthSystems of Mississippi (HSM) initially contracted with the Division of Medicaid to conduct the Peer/Utilization Review Organization for the state of Mississippi. The three year contract was renewed on July 1, 2001 and again on July 1, 2005.

In this capacity, HSM provides pre-certification and concurrent review for:

• Inpatient medical/surgical

• Acute psychiatric

• Swing bed

• Transplant

• Psychiatric Residential Treatment Facilities

• Private Duty Nursing

• Home Health

• Durable Medical Equipment, and

• Outpatient Physical, Occupational and Speech Therapy.

In addition, HSM conducts quality review in all established review settings and offers due process for any confirmed quality issues.

HSM's Practitioner Review Team consists of Mississippi-licensed practitioners that represent 28 specialties: Family Medicine, Pediatrics, Developmental Pediatrics, Pediatric Pulmonology, Pediatric Neonatology,  Internal Medicine, Adult Psychiatry, Child Psychiatry, Clinical Psychology, Obstetrics and Gynecology, ENT, Plastic Surgery, General Surgery, Orthopedic Surgery, Thoracic Surgery, Hand Surgery, Ophthalmology, Physical Therapy, Dentistry, Family Nurse Practice, Radiation Oncology, Audiology, Podiatry, Nephrology, Dermatology, Vascular Surgery, Optometry, Orthotist-Prosthetist.

HSM's Education department provides informational workshops and educational programs for all providers. Educational programs are available to providers through one-on-one meetings, telephone conferences, web casts and workshops.

It is our corporate goal, and the goal of each employee, to deliver the most responsive and effective service possible to the Division of Medicaid, as well as to Medicaid beneficiaries and the health care providers of Mississippi.