Is anyone else experiencing a delay on Blue Plus payments being delayed in Procentive? Money is in our account but no ERA... We are typically paid on Wednesdays... 

Thanks! 

Good morning!  Curious to know if other facilities have recently seen UCare denying claims with the CO-197 denial code (authorization) for claims you sent that had the authorization number attached and the auth was valid?  The two facilities I bill for, I've seen this happen with several clients on the past couple of remits, so trying to gauge if this might be a more global issue with them right now.

Wondering if anyone has ever come up against this.  Client has Part A Medicare, no Part B.  Client was in IOP and Aetna has processed claims as if Medicare is primary and adjusting off most of the charge. Aetna is telling us this is a penalty since the client declined Part B Medicare. I don't see how they can do this. They are penalizing us, not the member.

Thanks

Hello, we have noticed that over the last few weeks our HH ERAs are coming with a bunch of adjustments; even though they paid the full amount. It is causing me to go in and manually change all the lines before saving it. 

I am curious if anyone else has seen this?

BCBS posted a Provider Bulliten on 4/10/2019 stating that as of 5/1/2019 we should bill the R25 Assessment with the HF Modifier to distinguuish between it and the Comprehensive Assessment. 

Yesterday we received two ERAs for DOS January - April 2019 where they reprocessed ALL of our R25's as Comps since they were billed with no HF Modifier. The communication I have clearly states it went into effect on 5/1/2019. We get paid more for our R25 so it is resulting in a large takeback.

Thoughts?

Jeremy

Has anyone else noticed a delay in how long it takes to see ERAs from MN-ITS in Procentive?  There has has always been some lag, however we don't have our yet.  It looks like the files are available in MN-ITS as of 9/13 but not into Procentive yet....

Just wondering if others have received their ERAs for today.

Insurance termed so I posted the takeback to the clients account. What exactly are the next steps that I need to do so I can rebill this to secondary ins for the full amount of the claim???