How do I fix and resubmit a denied Medicaid claim?
Read the denial code, fix the cause, and resubmit before the deadline. In Georgia, denied claims with missing or wrong information are generally resubmitted within three months of the denial month, and the claim’s total life is capped at 365 days. Duplicates need no fix; find the paid claim.
Do the same five steps each time.
- Read the code on the remittance and write down what it means in plain words.
- Find the cause. Is it eligibility, authorization, EVV, a modifier, or a wrong ID?
- Fix the source, not just the claim. If the visit record is wrong, correct the visit first.
- Resubmit, using the right route. EVV-required claims go through the state EVV system.
- Check the next remittance to confirm it paid.
Georgia timing, from the state’s denial guidance:
- Resubmission of a denied claim: three months from the month of denial.
- Adjustment of a paid claim: three months from the month of payment.
- Total claim life: 365 days from the date of service.
When the cause is outside your control, such as a late authorization, ask your care coordinator or the state about extensions. Georgia law lets the commissioner extend for causes beyond your control, not beyond 12 months from the service month.
Keep a log of every denial: date, code, fix, result. Patterns show you what to change at the source.
How CareBravo® helps
A rejected record comes back explained in plain words, and nothing is resubmitted until the owner says Go ahead.
Sources
- Georgia Medicaid Common Denials webinar (Feb 2021) · Georgia DCH / GAMMIS
- Georgia Code 49-4-145: Time limitations on claims for assistance · Official Code of Georgia (via Justia)
Reviewed by Beth Bledsoe, Care Business Advisor®, 28 Oct 2026. Rules change. Confirm with your state Medicaid agency before you act.
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