Why was my claim denied for units or authorization?
Medicaid pays only for the units and dates that were authorized. If your claim has more units than the authorization allows, falls outside its dates, or lists a different provider ID, it denies. In Georgia these show as codes like 3052, 3011 and 3044. Prior authorization alone does not guarantee payment.
Think of an authorization as a permission slip with three parts: the dates, the number of units, and who may deliver the service. A claim must fit inside all three.
In Georgia, the common denials are:
- 3052: authorized units are used up. You billed more than the authorization holds.
- 3011: the date of service is outside the authorization dates.
- 3044: the provider ID on the claim does not match the one on the authorization.
- 3001: the authorization number is invalid or has not crossed over to GAMMIS.
The state says prior authorization does not guarantee payment. A claim can still deny if the client loses eligibility, if the billed code differs from the authorized code, or if you billed extra services that need their own authorization.
One trade article gives an example: 112 units (28 hours) a month for personal care. Visits booked outside the authorized period will not be paid.
What to do: check the authorization before you schedule, watch units left during the month, and ask your care coordinator early when a client needs more hours. EVV does not change the state’s authorized-unit rules.
How CareBravo® helps
Scheduling and billing use the same checked shifts, so a visit that would pass the authorization is easier to spot before the claim goes out.
Sources
- Georgia Medicaid Common Denials webinar (Feb 2021) · Georgia DCH / GAMMIS
- So You Want to Bill Medicaid · Home Care magazine
- Electronic Visit Verification (EVV): Provider-related FAQs · 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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