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:
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Inpatient medical/surgical
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Acute psychiatric
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Swing bed
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Transplant
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Psychiatric Residential Treatment Facilities
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Private Duty Nursing
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Home Health
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Durable Medical Equipment, and
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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.