Request for Claims History

Claim histories for faculty and residents are provided upon request.  To obtain a claim history, submit one of the following via email, fax or mail: 

• Signed Authorization to Release Information - PDF

• Written request from individual that explicitly gives UMMC consent to release claims history.

Please make certain to include full name, maiden name (if applicable), last four digits of social security number and/or UMMC Employee ID number.  Failure to include the above information will delay the processing of your request.  Please allow a minimum of seven business days to process the request.  Requests are accepted via email to claimshistory@umc.edu, fax to 601-984-1997, or mail to: 

University of Mississippi Medical Center
Attention: Office of General Counsel
Claim History Request
2500 North State Street
Jackson, MS 39216-4500