MedicaidAdministrativeHigh impact
Gainwell to implement new Claim Reconsideration Request Process
Mississippi Medicaid (DOM)·MS·Prior Authorization
We identified it
Sep 15, 2026
Summary
Gainwell has implemented a new Claim Reconsideration Request Process accessible through the MESA Provider Portal's Secure Correspondence feature. Providers must now submit reconsideration requests for denied claims (coding-related, non-timely filing issues) or improper payments through this portal rather than alternative methods, with tracking via Contact Tracking Number (CTN).
Action Required
Immediately: Billing team must transition all claim reconsideration requests to the MESA Provider Portal Secure Correspondence feature. Staff must: (1) Access the portal at https://portal.msxix.net/ms/provider/Home/tabid/135/Default.aspx using provider credentials; (2) Create new messages with Subject line containing EOB number from Remittance Advice; (3) Select 'Reconsideration Requests' in Message Category dropdown; (4) Complete all required fields including claim number (ICN), Date of Service, billed/paid amounts, Pay/Deny date, member information, and detailed explanation of reconsideration reason; (5) Attach supporting documentation (up to 20MB, file types: .gif, .jpg, .jpeg, .pdf, .png, .tif, .txt only; filename max 50 characters); (6) Track response status using the CTN provided in confirmation. Update all billing workflows, staff training, and appeal procedures to reflect this mandatory portal-based process. Failure to use the new process may result in delays in reconsideration reviews or requests being routed incorrectly.