Fee-for-Service Claims Processing Correction Notice

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Published March 30th, 2026

Detected March 31st, 2026

Summary

The Louisiana Department of Health issued a notice regarding a system error by Gainwell Technologies affecting fee-for-service claims processed on November 4 and December 9, 2025. Due to a ClaimsXten editing system failure, certain professional, outpatient hospital, and DME claims were paid without proper NCCI edits. LDH will void and reprocess affected claims beginning March 31, 2026.

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What changed

During the November 4 and December 9, 2025 claim cycles, Gainwell Technologies experienced a system error in the ClaimsXten (CXT) editing system that prevented certain fee-for-service professional, outpatient hospital, and durable medical equipment claims from receiving standard or National Correct Coding Initiative (NCCI) edits before payment. Affected claims paid in error have been identified and will be voided and reprocessed to apply proper denials.

Healthcare providers should expect to see claim voids on the March 31, 2026 remittance cycle, with corresponding denials appearing in the following cycle. No provider action is required as the system correction is being handled automatically. Gainwell Technologies has identified and resolved the root cause. Questions should be directed to Gainwell Provider Relations at (800) 473-2783 or (225) 924-5040.

What to do next

Monitor March 31, 2026 remittance advice for claim voids related to affected cycles
Review subsequent remittance cycles for denial adjustments on previously paid claims
Contact Gainwell Provider Relations at (800) 473-2783 with questions

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- Fee-for-Service Processing Issue – Nov. 4 and Dec. 9, 2025 Cycles

March 30, 2026 Fee-for-Service Processing Issue – Nov. 4 and Dec. 9, 2025 Cycles

Baton Rouge, Louisiana,

Mar 30, 2026

During the claim cycles on November 04 and December 9, 2025, Gainwell Technologies experienced a system error that prevented certain fee-for-service professional, outpatient hospital, and durable medical equipment (DME) claims from processing through the ClaimsXten (CXT) editing system. As a result, some claims were paid without the application of standard or National Correct Coding Initiative (NCCI) edits.

Affected claims that should have received CXT or NCCI denials have been identified. These claims will be voided and then reprocessed to ensure the proper denials are applied. Providers can expect to see the voids beginning with the March 31, 2026, remittance cycle and then the claim denials will appear in the following cycle.

Gainwell Technologies has worked to identify the root cause of the issue and they have successfully implemented a resolution.

General questions related to the addition of these codes should be directed to Gainwell Technologies Provider Relations at (800) 473-2783 or (225) 924-5040.

For updates and more information, providers are encouraged to monitor LDH communications and visit LaMedicaid.com.