MedicaidPrior AuthMedium impact
Provider Portal-Newborn Enrollment
Mississippi Medicaid (DOM)·MS·Prior Authorization
We identified it
Jun 21, 2026
Summary
Telligen has released a new Prior Authorization Change Request Form for Mississippi Medicaid that allows providers to request modifications to existing prior authorizations, such as adding modifiers or correcting service details. The form cannot be used for reconsiderations of denied PAs and must be submitted within 90 days of the PA approval date.
Action Required
Immediately: Billing team should bookmark and use the new PA Change Request Form (available at https://msmedicaid.telligen.com) for any modifications to existing Mississippi Medicaid prior authorizations. Submit completed forms via email to MSMedicaidUM@Telligen.com or fax to 800-524-5710. Ensure requests are submitted within 90 days of PA approval and void any paid claims before requesting PA changes.