MedicaidAdministrativeHigh impact
BT202144: FQHC/RHC wraparound supplemental professional claim processing to change July 1
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Claims & Billing
Effective date
Jul 1, 2021
We identified it
Jun 19, 2026
Summary
Starting July 1, 2021, FQHC and RHC wraparound supplemental payments for medical services will be processed automatically by Gainwell Technologies on a claim-by-claim basis instead of through monthly settlements with Myers and Stauffer. This change affects multiple Medicaid managed care entities and introduces new place of service codes and EOB codes.
Action Required
By July 1, 2021: FQHC and RHC billing teams must stop submitting wraparound payment requests to Myers and Stauffer for claims with dates of service on or after July 1, 2021. Update billing systems to recognize new EOB codes 3370, 3371, and 3372, and new A/R reason codes 8681 and 8682 on weekly Remittance Advice reports. Add place of service codes 02 (Telehealth), 03 (School), and 04 (Homeless Shelter) as allowable options for encounter claims. Monitor weekly RA reports for automatic wraparound payments instead of monthly settlement processes.