MedicaidAdministrativeHigh impact
BT2024130: IHCP has identified incorrect claim payments for Indiana PathWays for Aging members
Indiana Medicaid (IHCP)·IN·Claims & Billing
Effective date
Jul 1, 2024
We identified it
Jun 19, 2026
Summary
IHCP has identified and is recouping incorrectly paid fee-for-service claims for Indiana PathWays for Aging members with dates of service on or after July 1, 2024. Providers will see adjustments on remittance advices and must rebill the appropriate managed care entity for services after July 1, 2024.
Action Required
Immediately: Billing team must monitor remittance advices for claim adjustments with ICNs/Claim IDs beginning with '52' indicating recouped PathWays member claims. For any adjusted claims with DOS on or after July 1, 2024, rebill the appropriate managed care entity listed in member eligibility verification. For services on or before June 30, 2024, rebill to Gainwell Technologies. Split claims that span both date ranges. Verify PathWays member MCE assignment during eligibility checks to prevent future incorrect billing.