Medical Services

Providers who need assistance may call these numbers between 8:00 a.m. and 4:30 p.m. Central Time, Monday through Friday.

Prior approval for Physical Therapy, Occupational Therapy, Speech Therapy, Cardiac Rehabilitation and Pulmonary Rehabilitation visits.

  • Fax requests to the State Health Plan Medical Review Department: 601-664-5314

Pre-certification for the following services must be obtained by contacting ActiveHealth at 866-939-4721 or 866-617-4900 (fax):

  • Inpatient hospital admission — except routine maternity admissions
  • Inpatient rehabilitation
  • Residential Treatment Facility
  • Inpatient bariatric surgical procedures
  • Outpatient bariatric surgical procedures
  • Private duty and home health nursing
  • Solid organ and bone marrow/stem cell transplants
  • Home infusion therapy
  • Skilled Nursing Facility
  • Long Term Acute Care Facility
  • Hospice care
  • Wound Vacuum Assisted Closure
  • Diabetic self-management training/education
  • Low-Dose CT in adults ages 55 to 80 to screen for lung cancer

Prescription Medications

Certain prescription drugs require prior approval. The prescribing physician must contact Prime Therapeutics at 1-877-794-3574 for prior authorization. Examples of prescription drugs requiring prior authorization include, but are not limited to:

  • Medications for treating acne
  • Anabolic steroids
  • Brand name proton pump inhibitors
  • Medications for male impotency
  • Growth hormones for persons age 21 or older