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Mississippi Medicaid pharmacy plans and information

Mississippi Medicaid pharmacy billing for fee-for-service, coordinated care and Children’s Health Insurance Plans (CHIP)

Please print and post this chart nearby for a quick, easy reference.

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PlanClaims processorBIN (Banking info. #)PCN (Processor control #)Group IDPharmacy POS claims helpdeskPOS claims helpdesk Local NumberPA helpdeskPharmacy PA faxNetwork Reimbursement ID
Medicaid – fee for serviceConduent610084 DRMSPROD/SIPPI N/A 800-884-3222 1-800-884-3222 877-537-0722877-537-0720N/A
Magnolia Health Plan – CANEnvolve020545 RXA371 RXGMSSTD 800-460-8988 1-866-912-6285 ext. 66409866-399-0928877-386-4695RXA371
Molina Healthcare – CANCVS Caremark004336 MCAIDMS RX6436 800-364-6331 1-844-826-4335 844-826-4335844-312-6371MCAIDMS
United Healthcare – CANOptumRX 610494 4646 ACUMS 877-305-8952 601-718-6549 800-310-6826866-940-7328AMCMS4
SPP-MS
CHIP MagnoliaEnvolve020545 RXA372 RXGMSCHIP 800-460-8988 1-866-912-6285 ext. 66409866-399-0928877-386-4695RXA372
CHIP United HealthcareOptumRX 610494 4747 ACUMS 877-305-8952 601-718-6549 800-310-6826866-940-7328OMSCH1
OMSCH2
OMSCH4
SPMSCH

Version 6 – Effective Nov. 1, 2018