20 Miss. Code R. § 2-I

Current through June 25, 2024
Section 20-2-I - GENERAL PROVISIONS
A. Unresolved disputes over the amount charged for services rendered under the provisions of the Fee Schedule or over the amount of reimbursement for services rendered under the Fee Schedule may be appealed to and resolved by the MWCC. Regardless of the date of service, all changes to the dispute resolution procedures found in this edition of this section of the Fee Schedule shall be applied retroactively to all Requests for Resolution of Dispute or other documents filed on or after the effective date of this Fee Schedule.
B. Reconsideration must be sought by the provider or payer prior to a request for resolution of a dispute being sent to the MWCC. This provides the payer and provider an opportunity to resolve most concerns in a timely manner.
C. All communication between parties in dispute will be handled by the MWCC, Cost Containment Division. In addition, there will be no communication between the parties in dispute and any Peer Reviewer who might be called upon to assist the MWCC in the resolution of a dispute.
D. In the absence of any agreement between the parties submitted to the MWCC in writing, Requests for Resolution of Dispute shall not be ruled upon in claims for which the compensability of the underlying injury is currently disputed or denied by the payer. In the event the parties submit such an agreement, it shall be subject to the review and approval of the Cost Containment Division, and such agreement shall be recognized or denied in the sole discretion of the Cost Containment Division and/or the MWCC. Otherwise, Cost Containment Decisions for Requests for Resolution of Dispute may be held in abeyance pending a final adjudication and/or admission of compensability by the payer for the underlying injury in the dispute.

20 Miss. Code. R. § 2-I

Amended 6/14/2017
Amended 6/15/2019