Mississippi State Department of Health


Please Note

We are a service company that can help you file with the Mississippi State Department of Health. We are not associated with this nor any other government agency. We offer paid services and software to help you file. You are not required to purchase our service to file - you may file directly with this agency without using our service.


Contact Information

Phone: (601) 576-7400

Web: Home

Licenses

We track the following licenses with the Mississippi State Department of Health in order to provide compliance services to our clients. As a client, you see this and other reference data in License Manager in-line with your licenses.

A laptop placed on a desk with our License Manager software on display

Mississippi Backflow Prevention Assembly Tester Certification

Agency:Mississippi State Department of Health
Foreign Qualification is Prerequisite:No
Exam Required?Not Set
Registered Agent (Special Agency) Required?No

Initial Registration

Form:
Filing Method:

Online

Agency Fee:

$104 Examination Fee  + the associated ms.gov cost for processing the order + $50 certification fee 

Before you Apply:

Registration Renewal

Form:

Training Submittal Form 457E

Filing Method:

Online 

Agency Fee:

$30 certificate fee + processing fee

Due:

Triennially by date of issuance

Law:

15 Miss. Code R. § 20-72-1.14.7

Mississippi Private Review Agency Certification

Type of Review:

Medical Utilization Review

Agency:Mississippi State Department of Health
Law:

MS Code § 41-83-3

Foreign Qualification is Prerequisite:Not Set
Notes:

No certificate is required for those private review agents conducting general in-house utilization review for hospitals, home health agencies, preferred provider organizations or other managed care entities, clinics, private physician offices or any other health facility or entity, so long as the review does not result in the approval or denial of payment for hospital or medical services for a particular case.

Exam Required?Not Set
Registered Agent (Special Agency) Required?Not Set

Initial Registration

Agency Fee:

$1,150

Notes:

Contact the department for an application form.

Required Attachments:
  • Utilization review plan
  • A written protocol describing the appeals procedure
  • A copy of any form which shall be completed during the appeals procedure
  • Time frames that shall be met during the appeal procedure
  • The names and qualifications of personnel making final appeal determinations

Registration Renewal

Agency Fee:

$1,150

Due:

Biennially by the date of issuance.

Notes:

Contact the department for a renewal form.

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