MedicaidAdministrativeMedium impact
BT2024155: IHCP to mass adjust/reprocess CIH, FSW and TBI waiver claims that were denied incorrectly
Indiana Medicaid (IHCP)·IN · PM&R (Physical Medicine & Rehab), Occupational Therapy, Physical Therapy·Specialty Services
Effective date
Nov 6, 2024
We identified it
Jun 19, 2026
Summary
IHCP will automatically reprocess and adjust claims for Home Modification Assessment, Career Exploration and Planning, and Structured Family Caregiving services that were incorrectly denied between July 1-September 6, 2024. Providers will see adjusted payments on remittance advices starting November 6, 2024.
Action Required
Starting November 6, 2024: Billing team should monitor remittance advices for reprocessed claims with ICNs beginning with 52 or 80. Review and reconcile any adjusted payments for waiver services with dates of service July 1 - September 6, 2024. No action needed for future claims as system has been corrected.