Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Mississippi Division of Medicaid before sending sensitive documents. FaxFlow is not affiliated with this organization.

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Mississippi Division of Medicaid fax number

(228) 762-7309

Division of Medicaid

Used for: Outstation communications with the Mississippi Division of Medicaid; used for submitting Administrative/Claim documents, including Adjustment/Void Requests to the Pascagoula Regional Office.

Fax destination details

Department
Division of Medicaid
Purpose
Outstation communications with the Mississippi Division of Medicaid; used for submitting Administrative/Claim documents, including Adjustment/Void Requests to the Pascagoula Regional Office.
Form
Adjustment/Void Request — Submission of Adjustment/Void Request
Address
Pascagoula Regional Office, 1702 Denny Ave, Pascagoula, MS 39567
Voice phone
(228) 762-9591

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

When submitting an Adjustment/Void request, complete boxes 1 through 6 on the Adjustment/Void request form for proper processing. If filing for an adjustment with or without a returned check to Medicaid, attach a corrected claim and any other appropriate documentation that will aid in properly processing your request.

Official form instructions are published as a downloadable file on the organization's website.

Sources and verification

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