Mississippi Payer Configuration and Requirements Tables

The payer configuration table is a valuable resource to help you understand the specific requirements for each payer contract as they relate to the integration process. By referencing this table, you can ensure the correct configuration of payer contracts, maintain compliance, and streamline workflows. Use this topic as a quick reference to verify the scope of each payer’s requirements and to facilitate a smooth integration process.

Payer Configurations and Requirements	MS Division of Medicaid	State Plan Personal Care (PSC)	State Plan Home Health (HH)	MS Magnolia Health	MS Molina Healthcare	MS TrueCare
835s Availability	Not in Scope	Not in Scope	Not in Scope	Not in Scope	Not in Scope	Not in Scope
Billing Required	Not Required	Not Required	Not Required	Visit Invoicing Required in HHAeXchange. Direct Claim Submission to Payer.	Visit Invoicing Required in HHAeXchange. Direct Claim Submission to Payer.	Visit Invoicing Required in HHAeXchange. Direct Claim Submission to Payer.
Communications Module Availability	Available	Available	Available	Not in Scope	Not in Scope	Not in Scope
DX Code is Payer or Provider Managed	Provider Managed	Provider Managed	Provider Managed	Provider Managed	Provider Managed	Provider Managed
EVV Required	Required	Required	Required	Required	Required	Required
Payer GPS Tolerance	300 ft	300 ft	300 ft	300 ft	300 ft	300 ft
Missed Visits Required	Required	Required	Required	Required	Required	Required
POC Compliance Required	Personal Care Compliance	Not in Scope	Not in Scope	Optional	Optional	Optional
Rate is Payer or Provider Managed	Provider Managed	Provider Managed	Provider Managed	Provider Managed	Provider Managed	Provider Managed
Referring Physician Required	Not Required	Not Required	Not Required	Not Required	Not Required	Not Required