FQHC Contract Repapering: Frequently Asked Questions
Why am I getting this request?
Since system migrations to our parent company, Centene, have been completed, we have identified that all FQHCs contracted with any product lines (Meridian Medicaid, Wellcare Medicare, Ambetter from Meridian, Wellcare By Meridian) are not aligned with the proper pay classes in Centene’s internal systems. A pay class is identified each time a claim is entered, categorized by provider type. Legacy contracts with Meridian had all FQHCs categorized as a separate pay class as compared to Centene contracts. Therefore, claim payments have not been distributed properly.
What is the difference between my current contract and the new repapered contract?
The legacy contracts you currently have with Meridian do not contain specific FQHC reimbursement language, including which claim forms are needed when submitting claims to the Health Plan. The new contracts will include FQHC-specific language to prevent denials due to incorrect claim forms with our FQHC partners. There are no reimbursement changes. We will continue to follow MDHHS guidelines for our Medicaid lines of business, and CMS for our Medicare and Marketplace lines of business.
What do I need to do?
You will receive an email from one of our designated contract negotiators with a list of documentation needed for each GNPI associated with the FQHC. Please work with the contract negotiator, who will be overseeing the process of capturing signatures, ensuring credentialing applications and disclosure forms are up to date, and verifying any types of licensures affiliated with the contract.
What happens if I do not repaper my contract with Meridian?
If repapering is not implemented, the FQHC facility will continue to receive incorrect claim form denials from Meridian. This issue arises because the forms do not align with the Centene contract language for FQHC sites. The payment language in the contract would be opposite of how FQHC payments are currently configured.
Will there be any delays in payments if we are to repaper our contract?
No—there should be no breaks in reimbursement for your claims during the repapering process. This should not impact the health centers overall payments.
Who is the point of contact for repapering my contract?
Your point of contact for this repapering request is Contract Negotiator III, Alyssa Gajewski. She can be contacted via her email, alyssa.gajewski@mimeridian.com.
How long is the process for my new contract to be effective?
Typically, once the contracts have been signed externally and all additional documentation is included with the contract, the Contract Negotiator will forward the contracts to the Regional Vice President within one business day. The Regional Vice President will sign the contract the following day after the group has signed. Those will then be transferred to our PDE teams for loading and configuration, which could take up to 10-14 business days.