My Medicaid claim was rejected or denied in [state]. Who do I call and what should I check first?
Read the reason on the remittance or EVV report first. The most common causes are a missing EVV visit, no matching authorization, wrong dates or units, or an expired enrollment. Then call the state Medicaid provider line or EVV support. Fix the cause, then rebill, or file a corrected claim if your state requires it.
A denial is a message. Read it before you call.
Check first:
- The denial reason or code on your remittance advice or EVV claims report.
- EVV: does the visit exist, is it complete, and does it match the claim?
- Authorization: is there an active authorization for that client, service, and date?
- Eligibility: was the client covered on that date, and by which plan?
- Enrollment: is your Medicaid enrollment active and revalidated? Georgia, for example, said in May 2026 that providers not revalidated would be suspended on July 1, 2026.
- Units and codes: do they match what was authorized?
Then call:
- The state Medicaid provider services line.
- The EVV support line, if the issue is in EVV.
- The managed care plan, if the client is in one.
Rebilling rules differ. In Georgia, DCH slides say adjustments to paid or partly paid claims are made in the EVV system and a denied claim needs a new corrected claim.
Keep notes of each call: date, name, and what you were told. Check your state’s deadline for filing and appeals.
How CareBravo® helps
A rejected EVV record comes back explained in plain words and is resubmitted after the owner’s Go ahead.
Sources
- Electronic Visit Verification (EVV) Provider FAQs · Georgia DCH
- DCH EVV Implementation Town Hall presentation · Georgia DCH
- Provider Enrollment status page (revalidation alert, 25 May 2026) · Georgia Medicaid (GAMMIS)
- What’s New (EVV announcements) · Georgia DCH
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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