Medicaid Continues to Enroll Providers Who Have Missed the September 30, 2022 Deadline
Date: 10/04/22
Federal laws enforced by CMS, including the Affordable Care Act and the 21st Century Cures Act, require providers who file claims with Louisiana Medicaid to enroll in Medicaid's web-based provider enrollment portal. Providers affected by these laws include providers
enrolled in Fee for Service (FFS) Medicaid before December 31, 2021, and providers enrolled with an MCO, DBPM, or Magellan before March 31, 2022.
Despite being past the application deadline, the Provider Enrollment Portal remains open for providers required to enroll who have not yet applied. It is extremely important to act now to avoid disruption in payments. Read below for important information regarding claims denials for providers who missed the deadline.
Claims processing effective January 1, 2023:
- Scenario 1: Claims for dates of service before January 1, 2023, will be adjudicated for
providers who have and have not completed enrollment. - Scenario 2: Claims for dates of service after January 1, 2023, will be adjudicated for
providers who have completed enrollment. - Scenario 3: Providers who apply between October 1, 2022, and December 31, 2022, will be
able to resubmit claims for dates of service on or after January 1, 2023, that were denied for
failing to be fully enrolled. Once provider enrollment is complete, claims may be
resubmitted. - Scenario 4: Providers who do not apply between October 1, 2022, and December 31, 2022, will have their claims denied and may not resubmit claims with dates of service on or after January 1, 2023.
Provider Lookup Tool:
If providers are unsure of their enrollment status, a Provider Portal Enrollment Lookup Tool is available. Results will show the provider’s status as either enrollment complete, action required, application not submitted, or currently in process by Gainwell. Providers that are not shown in the results are not required to enroll at this time. Invitation letters for those providers will be sent at a later date. The Lookup Tool is updated daily.
Provider Resources:
For additional information, and to view the recording of the recent webinars or view a copy of the presentation are available on the LDH Provider Website.
Providers with questions are reminded to consult Informational Bulletin 22-4 which provides additional information on Medicaid Provider Enrollment and provider resources for questions.
Providers needing assistance with application and enrollment should contact Gainwell Technologies by emailing louisianaprovenroll@gainwelltechnologies.com or contacting 1-833-641-2140 for a status update on enrollment and any next steps needed to complete the process.