It has been brought to our attention that BCBS of Minnesota (ID SB720) has changed their requirements and are now requiring R&B codes to send before treatment codes on claims. As you may have noticed, all claims for R&B and treatment sent to BCBS of MN are being denied but are not given a denial reason. 

Thank you to all who have sent tickets relating to this issue. Through these tickets, and calls from our staff to the payer, we have succeeded in identifying this issue.  In the interest of saving your time, there is no need to call the payer on this issue as we are actively working on a resolution.

We are aware that this is a critical issue so please watch this post for an update. We will have more information available tomorrow (11/09/2017)

Thank you,

Care Team 

Hello Everyone,

Procentive has been made aware that the Ticketing Module and Workflow Module are flashing for staff who have items that require their attention - as they should - but when accessing the Module, no items will be flashing. 

We are actively working to resolve this, but in the mean time staff may wish to change the following setting to stop the flashing:

Settings Module > Preferences Tab > Ticketing Reminder Type > Solid

Updates will be added to this post as they become available.  

Edit: Testing has determined that this did not effect the Workflow Module.

Hello Everyone,

It has been brought to our attention that both Kiosk mode functionality, and sending forms to clients via. email and Client Portal have been intermittent. 

We have all available resources working to resolve this, and we will update this post when we have more information available. 

Thank you,

Pro Care Team

UHC has found an issue that is causing some ERAs from check date 09/27/2017 and forward from being sent. This applies to the following payers and IDs:

• AARP Insured By UnitedHealthcare Insurance Company ID 36273
• UnitedHealthcare ID 87726
• UnitedHealthcare Community Plan WI ID WID01
• UnitedHealthOne All Savers Insurance (AMS) ID 81400

We will update this post once we've received confirmation that this is resolved. 

Thank you!

Good afternoon,

We are currently aware of an issue that is not allowing users to register clients for the client portal. This is separate from the issue with workflow and appointment reminders. We are working on the solution now and will post an update here once we know more. We appreciate your patience!

ProCare Team

Good Morning!

We have received notice from DHS that there is a "time out" error occurring with eligibility as of 9:45 AM CDT. This is currently being worked on by the DHS Operations Team but there is no ETA at this time.

Please check back here for updates - we will post again when DHS has this resolved.

Thank you!

NGS Medicare has sent an email to all subscribed providers. For your convenience, this notice is below:

What Happened: 
National Government Services (NGS) is informing Part B providers of an issue involving claims that did not successfully crossover to the supplemental carrier. Provider remittance advice (RA) indicated in error that claims had automatically crossed over to the supplemental insurance carrier. Letters were later issued advising that claims could not be sent to the supplemental carrier due to the reported ICD-10 diagnosis code being truncated.
 
The codes are not truncated at this current date of service.
 
Why It Happened:
The issue occurred because the Benefits Coordination & Recovery Center (BCRC) edit validator may have installed “higher level of specificity” ICD-10 diagnosis codes a few weeks before 10/1/2017. The BCRC consolidates the activities that support the collection, management and reporting of other insurance coverage for Medicare beneficiaries. The purpose of the coordination of benefits (COB) program is to identify the health benefits available to a Medicare beneficiary and to coordinate the payment process to prevent mistaken Medicare payments. The BCRC coordinates with the Medicare Administrative Contractors (MACs) in crossing claims over to the supplemental insurers.
 
What This Means to You:
If you received one of these letters advising you the claim was not crossed over to the supplemental insurer, you will need to submit the claim directly to the secondary insurer. With the 2018 ICD-10 upgrade, the new diagnosis codes will go into effect on date of service 10/1/2017. Please be aware the changes to ICD-10 that may affect your practice.

If you would like to receive emails from NGS Medicare, please visit their website. After logging in or continuing as a guest, please click the "Subscribe to Email Updates" link on the top right (under the search box).

For consolidated providers MN MA (DHS) has ongoing problems with eligibility, which is causing some consolidated providers to be unable to check eligibility (except through IVR). The details from DHS are as follows:

Some MN–ITS transactions involving consolidated providers are experiencing issues, including: Eligibility Request (270), Authorization Request (278) and Service Agreement Request (278).
Consolidated providers who need to check eligibility or check the status of an authorization request or service agreement may call the Provider Call Center at 651-431-2700 or 800-366-5411. 

We have confirmed with DHS that this does apply to batch eligibility which how eligibility is checked through Procentive. If you wish to monitor the progress of this, you can find it on the MHCP Provider News and Updates page.

Once we know this has been fully resolved we will update this post.

Have a fantastic weekend!

As of 8/1/17 Humana has discontinued their Behavioral Health ID 61104. All claims for Humana should now be sent to the existing Humana ID 61101.

If you are submitting claims to Humana Behavioral Health using the payer ID 61104, you may see this rejection:

Error Code: RECEIVER_FAIL
Error Message: The payer ID is not valid. Please correct and resubmit the failed transactions.

If you receive the above rejection and have not already resubmitted under the Humana payer ID 61101, please submit a ticket to the Procentive Support Desk and we will update your Payers Module to use ID 61101.

Thank you!

We have been made aware that all claims sent to BCBS of MN (ID SB720) are returning with rejections, as seen in the Electronic Module with a status of "Has Rejections". The rejection message reported on the batch report is as follows:

Category: Acknowledgement/Rejected for relational field in error. Status: Submitter not approved for electronic claim submissions on behalf of this entity. Entity: Submitter.

This is currently being researched with the clearinghouse as the issue seems to span all agencies. When more information is available we will post it here for you.

At this time, please do not resend claims; we will let you know if this changes. 

Thank you!