Mississippi Code
General Provisions
§ 83-51-15. Denial of claims; appeal; prior authorization

1. Another payor is responsible for the payment;
2. The dentist has already been paid for the procedures identified on the claim;
3. The claim was submitted fraudulently or the prior authorization was based in whole or material part on erroneous information provided to the dental service contractor by the dentist, patient, or other person not related to the carrier; or
4. The person receiving the procedure was not eligible to receive the procedure on the date of service and the dental service contractor did not know, and with the exercise of reasonable care could not have known, of the person's eligibility status.

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