New payer requirement – Mississippi Medicaid has announced a new process for reconsideration of paper and electronic claims

Mississippi Medicaid has announced a new process for reconsideration of paper and electronic claims, effective Monday, December 12, 2022.

The process for reconsideration of claims has changed with the transfer of fiscal agent operations from Conduent to Gainwell Technologies which took effect October, 3, 2022.

Denied claims should be submitted as new day claims with appropriate supporting documentation. Submission options include;

Please note: Electronically submitted claims with attachments must include the new Claim Attachment Form. Please use the link below to access.

https://medicaid.ms.gov/wp-content/uploads/2022/12/Claim-Attachment-Form.pdf.

A comprehensive list of EOBs can be located using the link below:

https://medicaid.ms.gov/wp-content/uploads/2022/11/Mississippi-Medicaid-Explanation-of-Benefits_112822.pdf.

The full article may be read here: https://medicaid.ms.gov/wp-content/uploads/2022/12/Late-Breaking-News_121222.pdf.

We have taken additional steps to verify with our Clearinghouse Vendors how they are handling this new process change for resubmission and the impact this may have on your Providers.

Posted in: Uncategorized