Mississippi Sample Letter for Request for Authorization to Release Funds

State:
Multi-State
Control #:
US-0660LTR
Format:
Word; 
Rich Text
Instant download

Description

This form is a sample letter in Word format covering the subject matter of the title of the form.

How to fill out Sample Letter For Request For Authorization To Release Funds?

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FAQ

Call 1-800-421-2408 (Deaf and Hard of Hearing VP: 1-228-206-6062). For more information, read our Notice of Non-Discrimination.

Medicaid is separate from Medicare. Total monthly income can be no more than 135 percent of the federal poverty level: $1,691 per month for an individual, or ? $2,269 per month for a couple. For couples, income is calculated using income of both members of the couple, even if only one member is applying.

Mississippi Medicaid health benefits are available for many populations including children, low income families, aged, blind or disabled, and pregnant women. Individuals must meet certain requirements to receive benefits and services. The benefits you qualify for depends on your income, age, family size and situation.

They must have limited income, limited assets, and a medical need for care. A single individual applying for Nursing Home Medicaid in 2023 in Mississippi must meet the following criteria: 1) Have income under $2,742 / month 2) Have assets under $4,000 3) Require the level of care provided in a nursing home facility.

Mississippi Medicaid includes multiple health benefits programs administered by DOM: fee-for-service Medicaid, MississippiCAN and CHIP. The federal medical assistance percentage (FMAP) is used to calculate federal matching funds for medical service expenditures.

Alliant Health Solutions is the current vendor responsible for prior authorization requests for fee-for-service (FFS) Medicaid beneficiaries. Please click here to direct you to the Alliant official website, or call Alliant directly at 1-888-224-3067.

Claims for covered services must be filed within 12 months from the through/ending date of service. Providers are encouraged to submit their claims as soon as possible after the dates of service.

To request a hearing: Contact the Medicaid regional office shown on your notice ? in person, via mail, by telephone, or through other commonly accepted electronic means such as fax or e-mail. Tell us you want to appeal the action taken on your case. Tell us if you want a local or state hearing.

Mississippi Health Benefits for Children Health benefits for children from birth to age 19 are provided through Medicaid.

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Mississippi Sample Letter for Request for Authorization to Release Funds