MS HB891

Establishes standardized credentialing process for health care providers (physicians, physician assistants, nurse practitioners, and advanced practice registered nurses) seeking approval from Medicaid managed care organizations, with completion required within 90 days of receiving complete application (30 days if provider already has Medicaid provider number).

Requires managed care organizations to notify applicants within 30 days of application receipt about any defects or incomplete information, and within 60 days if needed verifications have not been received.

Mandates use of Mississippi Standardized Credentialing Application Form for uniform submission of applicant information across managed care organizations until electronic submission becomes available.

Permits interim credentialing allowing managed care organizations to pay contracted reimbursement rates for services rendered by newly credentialed or previously credentialed providers within provider groups before full credentialing completion.

Requires all claim payments to include itemized accounting with specific information including patient name, Medicaid claim number, service dates, CPT codes, amounts allowed, patient due amounts, and payment reimbursement; specifies additional requirements for denied claims and secondary payer situations.