Procentive customers may have received denials from BCBS with a CARC denial code 97 or 18 for dates of service 9/26 - current. Per Blue Cross, they had a glitch in their system where it appeared that the claims came through twice and the first claim is the one with the denials. The other claims that paid should be coming through in the future on an ERA. BCBS is requesting up to 30 days for them to resolve, process, and pay these DOS.

We received the following email from OptumInsight regarding ERAs for UBH. On some ERAs from UBH, the system is not recognizing the client on the ERA. Some of the claims in the ERA will match correctly, but others will not because of this issue. In the email below, Optum says that no provider action is required at this time. They also do not have an ETA on the resolution of this issue either.

If you recognize this problem in your UBH ERAs, we recommend waiting to post these for now. Hopefully, Optum will resolve the issue soon, and they will provide instructions at that time on how to fully resolve the problem.

Once we receive more information, we will update this post.

From: Pennie, Rachel E
Date: Mon, Oct 3, 2016 at 2:53 PM
Subject: OptumInsight System Notification - ERA Issues
To:

Hello

I was wondering what other users do with the random paper EOBs that come from private payers when the payment does not come electronically? We would like to be completely paperless and I always feel as if I have to keep these EOBs and I just dont know which module to save it under. I dont want to put it in clinical/charting because it is not clinical and the only other place I could think of is client/payers. Looking for suggestions.

Thanks~