Search results with tag "04 claim form instructions"

Mississippi Medicaid Provider Billing Handbook Section: …

May 03, 2017 · Claim Mailing Address . Once the claim form has been completed and checked for accuracy, please mail the completed claim form to: Mississippi Medicaid Program P. O. Box 23076 Jackson, MS 39225-3076 . UB-04 Claim Form Instructions Page 3 of 17

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