| Mississippi WORKERS COMPENSATION COLLECTION PUBLICATIONS AND INFORMATION FOR MEDICAL PROVIDERS |
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- Medical Control
The injured employee may accept the physician services furnished by the employer or choose
his/her own treating physician. The treating physician may make one referral to a physician within
a specialty or subspecialty area. Any change in treating physician or further referrals must be
approved by the employer/insurer. If denied, the injured employee may apply to the Workers'
Compensation Commission for authorization. If the injured employee accepted the employer's
physician, it does not count as a choice and the injured employee has the right to change to a
physician of his/her choice at any time. The employee may select his/her own pharmacy or select
a pharmacy from the Express Scripts pharmacy network. Emergency medical care does not require
preapproval and should be secured at the nearest location.
- State Fee Schedule
Inpatient rates are based on a daily per diem depending on the type of stay, surgical, medical, etc.
When specific criteria are met, an additional Stop Loss amount may be paid, which is 80% of the
additional allowable amount.
INPATIENT SERVICES
The Mississippi Inpatient Base Rate as of October 1, 2011 is $10,419.48. This base rate will be
used to calculate the reimbursement of a Mississippi Workers’ Compensation inpatient hospital
claim for all discharge dates on or after October 1, 2011.
The maximum reimbursement for an inpatient claim is determined by multiplying the
Mississippi base rate times the current (FY 2011) MS-DRG relative weight. The most current
DRG Relative Weight table is included with this update.
December 20, 2011: Mississippi News: Notice
Attorney Information on Pleadings