- +1 (773) 985-1869
- info@stream-rcm.com
- 14430 Ocean Point, El Paso, TX 79938
Stream RCM provides medical billing services in Mississippi, handling coding, claim submission, payment posting, denial management, and credentialing for physicians, clinics, and multi-specialty groups. Our certified coders hold AAPC certification. We handle claims for Medicare, private insurers, Mississippi Medicaid, including MississippiCAN plans and CHIP. Our rates start at 2.99% of your monthly collections. You can track claim updates in real time.
Mississippi Medicaid covered 641,565 people in June 2026, and most of them aren’t billed to the state directly. About 69% are enrolled in MississippiCAN through Magnolia Health, Molina Healthcare or TrueCare. Each plan sets its own prior authorization and claim rules. The plan lineup changed recently too. UnitedHealthcare left MississippiCAN on June 30, 2025, after covering 151,257 members in May, and TrueCare joined the next day.
MississippiCAN Share
Residents on Medicaid or CHIP
Yearly Enrollment Drop
Each medical specialty has different coding needs. A pediatric visit billed to CHIP needs different checks than a cardiology claim with several procedures. Stream RCM supports more than 50 specialties. Our coders review documentation, modifiers and payer policy for each one before a claim goes out. The medical list covers behavioral health, family medicine, OB/GYN, oncology, radiology and urology, along with many others.
Stream RCM has worked in revenue cycle management for more than 15 years, through many payer rule and code set changes. If you’re comparing medical billing companies in Mississippi, ask each one for real numbers and compare them with your own results. Here are ours.
Accurate medical billing and coding in Mississippi depends on fixing small errors before they reach the payer. Here’s how our team handles each step of the billing process.
Patient Information
Insurance EligibilityClinical Coding
Complete Charge
Claim
Payment
Denial
A/R and PatientIncorrect patient details can cause claim rejections before a payer even reviews the services. We check the patient's legal name, date of birth, address and member ID against insurance records. We also confirm whether coverage is through fee-for-service Medicaid, MississippiCAN or CHIP. Each program has different billing rules, so catching errors early helps prevent claim rejections.
Before every session, our medical billers and Coders verify copays, prior authorization requirements, plan assignment, and valid coverage. For Medicaid patients, we search the MESA Provider Portal to see whether they are fee-for-service or enrolled in one of the three MississippiCAN plans. Because members can switch plans, we recheck assignments at every visit. See our insurance eligibility verification services.
Our certified coders work from the provider's note and select the CPT, ICD-10-CM and HCPCS codes that match it. We check modifiers and billing units against NCCI edits, which Mississippi Medicaid also uses to catch billing errors. If a note doesn't support the level of service billed, we ask the provider before the claim is sent.
Missed charges are lost revenue that never appears on a denial report. We compare encounter notes with posted charges, including injections, supplies, labs and add-on codes. Groups with several providers or hospital rounds tend to have the most gaps. We reconcile charges for each account on a set schedule and close each gap before the claim is built.
Mississippi claims go to different places. Fee-for-service Medicaid claims go through MESA, run by Gainwell Technologies. MississippiCAN claims go to the member's health plan. Medicare Part A and B claims go to Novitas Solutions, Mississippi's Jurisdiction H Medicare Administrative Contractor. We check each claim for payer-specific requirements before submission. If a claim is rejected, we correct the errors and resubmit it.
We post remittance advice from MESA, health plan ERAs and paper checks, then match adjustments and patient balances to each claim line. If a payer pays less than your contract or the Medicaid fee schedule allows, we flag it. For our clients, 90% of claims are paid within 30 days, though some payers move slower than others.
Every denial starts with one question: why was it denied? The cause may be eligibility, authorization, coding, late filing or provider enrollment. Enrollment needs attention in Mississippi because revalidation notices arrive about 60 days ahead, and a late response can lead to termination. With our denial management services, practices have reduced claim denials by up to 75%.
We sort unpaid claims by age and dollar amount, and claims close to their timely filing limit go first. Our billing team checks payer portals, calls when status is unclear, sends corrected claims and files appeals the record supports. This steady follow-up on older balances is a big reason Stream RCM clients see 40–50% higher collections.
Running billing in-house costs more than a salary. You also pay for benefits, training, software and backup staff when a biller is out. When you outsource medical billing services in Mississippi, most of those fixed costs become one fee based on what you collect. Your savings depend on practice size and payer mix.
| Billing Consideration | In-House Billing | Outsourced Stream RCM |
|---|---|---|
| Staffing Structure | Hiring, training and covering for absences | Certified billing team assigned to your account |
| Claim Performance | Depends on staff experience and claim checks | 99% clean claim rate |
| Denial Management | Staff work denials between other tasks | Root-cause review with payer follow-up |
| Operating Cost | Fixed payroll, benefits and software costs | 40–50% cost savings |
| Performance Visibility | Reports depend on in-house tools | Real-time reporting on claims, denials and A/R |
Give us the full revenue cycle, or just the parts your staff can’t keep up with.
Each claim is built, checked, sent and tracked. If one comes back rejected, we fix it before payment stalls.
Our certified medical coders match every code on the claim to the chart and apply modifiers each payer accepts.
Every denial has a cause, and we find it. Then we correct the claim or appeal with supporting records.
We prioritize unpaid balances through payer calls, status checks and corrected claims until each claim is paid or closed.
Our provider credentialing services cover Medicaid enrollment, MESA revalidation, Medicare, and commercial payer applications.
CMS tracks Medicare enrollment in each of Mississippi’s 82 counties. These counts show where Medicare Advantage plans shape billing the most.
Harrison County had 42,446 Medicare-eligible residents, and 52.3% chose Medicare Advantage, so plan checks come before every claim.
In Hinds County, 58.5% of 41,355 Medicare eligibles used Medicare Advantage, sending most Medicare claims to private plans.
DeSoto County counted 29,023 Medicare eligibles. With 40.9% in Medicare Advantage, most Medicare claims still go to Novitas.
Of Jackson County's 28,762 Medicare eligibles, 54.1% were in Medicare Advantage plans with their own authorization rules.
Rankin County's 28,123 Medicare eligibles lean toward Original Medicare, with only 37.6% enrolled in Medicare Advantage plans.
Madison County had 20,312 Medicare eligibles, and about 63% stayed in Original Medicare, with claims billed through Novitas.
Tupelo sits in Lee County, where 37.4% of 17,753 Medicare eligibles were enrolled in Medicare Advantage plans.
Forrest County's 15,110 Medicare-eligible residents are split almost evenly, with 50.8% enrolled in Medicare Advantage plans.
Meridian practices in Lauderdale County serve a market of 14,885 Medicare eligibles, 43.6% of them in Medicare Advantage.
Jones County recorded 14,244 Medicare eligibles. Nearly half, 48.2%, used Medicare Advantage, so payer checks matter at intake.
These figures come from Stream RCM client accounts across many specialties. Your results will depend on your starting point and the payers you work with.
House Bill 3650 protects current provider reimbursement rates through July 2028, giving practices more predictability during an otherwise unsettled transition period.
Yes. We follow the Attorney General’s oversight of contracted plans closely and adjust our appeal and follow-up strategy as payer behavior shifts.
Providers must be fully credentialed with each contracted plan by December 31, 2026, or risk removal from that plan’s network starting January 1, 2027.
Yes. We regularly bill Tricare for practices serving the military communities around Fort Sill and Tinker Air Force Base, alongside civilian payer claims.
Yes, we have experience billing for tribal and IHS-affiliated facilities, accounting for the specific documentation and reimbursement pathways those sites follow.
Onboarding starts with a claims and credentialing review, followed by workflow alignment. Most practices begin submitting claims through us within the first few weeks.
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