Mississippi Claims Dispute & Statutory Guide
Mississippi operates an At-Fault automobile insurance framework under Title 63 and Title 83 of the Mississippi Code. The state follows pure comparative fault. Medical Payments (MedPay) coverage is optional and strictly subject to Mississippi's Made-Whole doctrine. Healthcare providers enforce statutory medical liens on personal injury recoveries under Miss. Code Ann. § 85-7-281.
Statutory Framework & Jurisdiction
At-Fault / Traditional Tort (Pure Comparative Fault & Statutory Healthcare Liens)
Mississippi is a traditional tort jurisdiction enforcing pure comparative negligence (Miss. Code Ann. § 11-7-15), allowing an injured party to recover damages regardless of their percentage of fault, reduced in proportion to negligence. Personal Injury Protection (PIP) is not mandated. Medical expenses are billed to optional first-party Medical Payments (MedPay) coverage, private health insurance, or the at-fault driver's liability policy. Under Mississippi Supreme Court precedent, MedPay insurers cannot subrogate until the patient is completely made whole. Healthcare providers secure unpaid medical receivables through statutory liens under Miss. Code Ann. § 85-7-281.
PIP / MedPay Coverage & Medical Fee Rules
optional Med Pay Coverage
MedPay is optional in Mississippi (typically $1,000 to $10,000+ per person), covering reasonable medical, surgical, dental, hospital, and ambulance expenses incurred as a result of an automobile collision
made Whole Doctrine
Under Mississippi common law (Hare v. State; City of Tupelo v. McRae), an insurer's contractual subrogation right for MedPay benefits cannot be enforced until the insured has been fully compensated for all economic and non-economic losses
assignment Of Benefits
Healthcare providers routinely accept patient assignments of MedPay benefits for direct claims submission
Official Medical Fee Schedule & Reimbursement Standards
name
Reasonable and Customary Fee Standard
rules
Mississippi does not establish a statutory fee schedule table for motor vehicle accident medical bills. Providers bill based on reasonable and customary charges prevailing in the local medical community for comparable care.
cpt Basis
CPT/HCPCS itemized coding on standard CMS-1500 or UB-04 billing claims
Preauthorization & Decision Point Review
requirement
Preauthorization is not required by statute for emergency medical stabilization or initial acute management. Elective surgical interventions and prolonged physical therapy regimens are evaluated under insurer medical necessity guidelines.
carrier Examinations
Under standard auto policy terms, insurers may request medical records or independent physician reviews to evaluate causal relationship to the motor vehicle crash.
Administrative Appeals & Dispute Mechanism
clean Claims Statute
Under Miss. Code Ann. § 83-9-5, insurers must pay clean medical claims within 25 calendar days for electronic submissions (35 days for paper submissions) or provide written notice of reasons for non-payment. Overdue clean claims accrue statutory interest at 1.5% per month.
medical Provider Lien Statute
Under Miss. Code Ann. § 85-7-281 et seq., hospitals, physicians, and nurses have a statutory lien upon personal injury judgments and settlements for reasonable medical, surgical, and nursing care. Notice of the lien must be filed in the office of the chancery clerk of the county where services were rendered prior to disbursement of settlement funds.
dispute Forum
Mississippi Circuit Court or County Court for civil recovery actions.
Critical Statutory & Dispute Deadlines
| Dispute Phase / Trigger Event | Statutory Timeline / Deadline |
|---|---|
| Accident Notice | Notice to insurer as soon as reasonably practicable |
| MedPay Claim Submission | Submission within standard policy billing deadlines (typically 1 to 3 years) |
| Clean Claim Payment Window | 25 calendar days for electronic claims; 35 days for paper claims (Miss. Code Ann. § 83-9-5) |
| Chancery Lien Filing | Must be filed with county chancery court clerk before settlement funds are disbursed (Miss. Code Ann. § 85-7-283) |
| Statute of Limitations | 3 years from accident date for personal injury tort claims (Miss. Code Ann. § 15-1-49); 3 years for contract claims |
Required Evidentiary Filing Checklist
- ✓Mississippi MedPay Claim Application Form
- ✓Executed Assignment of Benefits (AOB) and medical records authorization
- ✓Itemized CMS-1500 or UB-04 billing form with CPT/HCPCS codes and ICD-10 diagnostic coding
- ✓Contemporaneous medical records, emergency department documentation, and diagnostic scan reports
- ✓Filed Notice of Medical Lien with chancery court clerk recording stamp (for provider lien claims under Miss. Code Ann. § 85-7-283)
- ✓Insurer Explanation of Benefits (EOB) or written explanation of claim determination
Official Primary Sources & Legislative Authorities
Governing Regulatory Authorities
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