Kepro is honored to provide the utilization review and quality improvement programs for advanced diagnostic imaging services under the contract with the Mississippi Division of Medicaid (DOM). Our goal is to ensure benefits are provided for medically necessary services, based on DOM-approved criteria. We review non-emergency, outpatient prior authorization and retrospective review requests for fee-for-service Medicaid recipients (those not enrolled in managed care organizations).
Over the past 35 years, Kepro has partnered with government-sponsored and commercial payers across the country to improve healthcare quality, maximize efficiency, and achieve better healthcare outcomes. Kepro provides technology enabled services for priority populations to help them remain in the community of their choice. Serving more than 300 clients within federal, state, and local governments, Kepro has improved the lives of more than 77 million beneficiaries nationwide and we look forward to a long and successful relationship with Mississippi healthcare providers. For additional information, please visit Kepro’s website.
New Prior Authorization Provider Portal Available for Registration
As previously announced, the Mississippi Division of Medicaid (DOM) will transition to Telligen, a new Utilization Management/Quality Improvement Organization (UM/QIO), in early 2024.
To ensure you have adequate time to transition we ask that beginning December 1, 2023, providers begin registering with Telligen for the purpose of submitting prior authorization requests for Medicaid fee-for-service (FFS) members. Telligen will be the UM/QIO vendor to replace the following:
Providers are advised to visit Telligen’s Mississippi UM/QIO website beginning December 1, 2023 to register for portal access. Look for the Provider Portal Registration option, as indicated in the red box below. https://msmedicaid.telligen.com.
Please note: Prior authorizations for members enrolled in MississippiCAN and CHIP will continue to be handled by the respective coordinated care organization.