If You Need…

Contact…

A copy of the Plan Document
To verify coverage of a service
Medical claim forms
To appeal the level of coverage for a medical service

Blue Cross & Blue Shield of Mississippi
P. O. Box 23734
Jackson, MS 39225-3734
Toll-free: 800-709-7881

To locate a participating provider

AHS State Network
P. O. Box 23070
Jackson, MS 39225
Toll-free: 800-294-6307

A prescription drug claim form
A copy of the Preferred Drug List
A Mail Order form
To refill or track a mail order prescription

Catalyst Rx
Direct Member Reimbursement
P. O. Box 1069
Rockville, MD 20849-1069
866-757-7839

To certify an in-patient admission, an outpatient MRI, an outpatient CAT Scan, private duty or home health nursing services, solid organ or tissue transplant, home infusion therapy services, Skilled Nursing Facility admission, Long Term Acute Care Facility admission, Hospice Care service, or wound vacuum assisted closure device
To obtain an out-of-network review

ActiveHealth
6501 S. Fiddler’s Green Circle Suite 320
Greenwood Village, CO 80111
866-939-4721

Answers to general questions about the Plan’s life insurance policy

Minnesota Life
400 Robert Street North
St. Paul, Minnesota 55101-2098
866-293-6047

To contact the Plan Sponsor

Department of Finance and Administration
Office of Insurance
P. O. Box 24208
Jackson, MS 39225-4208
Toll-free: 866-586-2781
Local: 601-359-3411

FAQs