On July 1, 1997, HealthSystems of Mississippi (HSM)
was initially contracted with the Division of Medicaid to conduct
the Peer/Utilization Review Organization for the state of
Mississippi. The contract was renewed on July 1, 2001, July 1, 2005
and January 1, 2009.
In this capacity, HSM provides pre-certification and
concurrent review for:
Inpatient Acute Hospitals.
Standing Psychiatric Inpatient Hospitals.
Psychiatric Residential Treatment Facilities.
– Mississippi Youth Programs Around the Clock.
Hospital Outpatient Mental Health Services.
Outpatient Physical, Occupational and Speech Therapy.
Durable Medical Equipment, Orthotics, Prosthetics and Supplies.
Private Duty Nursing.
Medical Necessity Review for
Mental Health Services
In addition, HSM conducts quality review in all
established review settings and offers due process for any confirmed
HSM's Practitioner Review Team consists of
Mississippi-licensed practitioners that represent 28 specialties: Family
Medicine, Pediatrics, Developmental Pediatrics, Pediatric Pulmonology,
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.