MedicaidAdministrativeMedium impact
Remittance Advice Modified to Reflect Changes to Claim Adjustment Calculations
Wisconsin Medicaid (ForwardHealth)·WI·Billing
Effective date
Apr 1, 2011
We identified it
Jun 20, 2026
Summary
ForwardHealth modified how claim adjustments appear on Remittance Advice reports. Instead of showing net differences, the system will now recoup the entire original payment and issue full payment for the adjusted claim, requiring billing teams to update their reconciliation processes.
Action Required
By April 1, 2011: Billing team must update reconciliation procedures to account for new RA format showing full recoupments and full repaymentsrather than net differences. Review billing system's 835 transaction processing to ensure compatibility with the modified payment structure. Update staff training on interpreting the new 'Previous ICN' and 'Amount Recouped In Current Cycle' columns in the Accounts Receivable section.