Thank you all for your notifications and examples on the tickets you submitted.  Those specific examples were critical in determining the remaining fixes needed.  We, at Procentive and BillCare, understand this was an inconvenience to you, both yesterday and today, as we actively determined cause and fixed each issue as it became aware.  I sincerely apologize.  As we continue to enhance our product for you, it is not our intent to release enhancements causing undesired ramifications.

Please know we take this very seriously and we will be meeting to determine what did and didn’t work in the enhancement process.  I have noted the ProCare User Community’s comments/wishes and I will take them into consideration to improve our communication to you moving forward. 

If you have any additional questions/concerns or may still be experiencing issues, please submit a ticket for assistance from our Care Team. 

Alicia Swanson

Procentive servers are down right now. We are working to resolve the issue ASAP and will update this post once we have more information.

This article is no longer accurate. Please review this topic instead.

As of January 1, 2018 Tricare will be making the following changes:

• Claims contractor will no longer be PGBA
• New claims contractor will be Health Net Federal Services (HNFS)
• North Region and South Region are being removed
• East Region will replace the previous North and South Regions

What does this mean for you?

If you are a Tricare provider and would like to continue receiving EFT and ERA, you will need to fill out and submit the following applications:

• For ERA: Tricare 2018 ERA Pre-Enrollment Application
• For EFT:  Tricare 2018 EFT Pre-Enrollment Application

You may have received these applications in the mail however, we want to make this process as easy as possible for you so we have re-created these paper forms as fillable PDF documents! 

Please submit these completed applications to:

HNFS at 1-888-282-2841 Attn: T2017 West EFT/ERA

AND

Procentive at 1-888-354-9053 (ERA application only)

If we do not receive a copy, we will be unable to assist you in the application process.

Thank you!

We have received notice from the clearinghouse that claims sent to Cigna after August 19, 2017  with any of the following diagnoses were rejected in error:

The affected claims were rejected with the following rejection messages:

A3:254 - Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system. Principal Diagnosis Code for Service(s) Rendered.
A3:255 - Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system. Diagnosis Code for Service(s) Rendered.

If this applies to you:

Cigna is working to resolve the issue.
•  Claims that rejected on or after 08/20/2017 will be identified and corrected.

•  No action is needed. Estimated Completion Date: TBD
•  An updated batch report will be sent upon the correction of the rejected claims.

Thank you!

In order to prevent errors in claim submission and speed up the payment process for customers, Procentive recently started scrubbing claims data for extra spaces in areas like the client's name, address, policy ID, etc.

Today, for certain payers (not all of them), the system is showing an error that says, "The client's middle name may not have spaces before or after." In some cases, the error is a false error (meaning, there is not actually an extra space in the middle initial).

This problem will be resolved by tomorrow morning, as soon as our system updates overnight tonight.

Once the solution is confirmed to be working, we will update this post.

Thank you,

Kevin Holmes

We are currently experiencing an issue and we're working to resolve this. It should be back to normal shortly. Thank you for your patience.

Attention Procentive Users:

Thank you for your patience. The maintenance last night was successful and this issue should now be resolved.

Attention Procentive Customers:

Customers that utilize the NewCrop ePrescribing module may be experiencing delays or connectivity issues.

Our team is working to resolve this as quickly as possible.

For more updates and to subscribe for future updates, please refer to the NewCrop status page:

NewCrop Status Page

We will provide another update once resolved.

If you have any additional questions or concerns, please reach out to our support team via the Therapy Brands Community Portal.

UPDATE:

Attention Procentive Customers:

We believe this issue has been resolved.

If you are experiencing any continued issues with the ePrescribe module, please reach out to our support team via the Therapy Brands Community Portal.

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Attention Procentive Customers:

Customers that utilize the NewCrop ePrescribing module may be experiencing delays.

Our team is working to resolve this as quickly as possible.

For more updates and to subscribe for future updates, please refer to the NewCrop status page:

NewCrop Status Page

We will provide another update once resolved.

If you have any additional questions or concerns, please reach out to our support team via the Therapy Brands Community Portal.

RESOLVED:

Dear valued customer,

We can confirm that the issue we reported yesterday, regarding disruption to claims submitted electronically to Availity and DHS, has been resolved.

You will need to take the following actions:

Your Actions:

If you use our Billcare/RCM services, we will resubmit on your behalf.

If you do not use our Billcare/RCM services and submit your own claims, please take the following actions:

1. Go to the Electronic Module
2. Find all claims with date between 6/6/2024 and 6/12/2024, inclusive that still show a status of “Sent” or “No Response”
3. Click the invoice number
4. Select services you want to send
5. Click “Resend” button at bottom

Please note that the deadline for the upcoming DHS billing cycle is today, Thursday 06/13/2024.

If you have any questions regarding this issue and what action you should take, please submit a support case through your portal.

Thank you for your patience and understanding while we worked to resolve this issue.

Regards

Andrew Clement

VP Customer Success

UPDATE:

Attention Procentive Customers:

We have identified an issue with claims submissions that started on June 6, 2024, and continues to be ongoing. We are actively and urgently working to resolve this issue.

Issue:

Since June 6, 2024, claims submitted electronically to Availity and DHS only have been disrupted. Claims that appear “sent” may not have been transmitted. Unfortunately, we are unable to determine which claims have been transmitted, but we believe the majority have not.

We know that the deadline for the upcoming DHS billing cycle is Thursday, June 13, 2024.

Do not submit any more electronic claims to Availity or DHS via Procentive until we have confirmed this issue is resolved.

We expect the issue to be resolved tonight, June 12, 2024.

When we have confirmed this is resolved, you will need to take the following actions tomorrow:

Your Actions:

1. If you use our RCM services, we will resubmit on your behalf after resolving the issue.
2. If you do not use our RCM services and submit your own claims, please take the following actions after we have confirmed the issue is resolved:
   1. Go to the Electronic Module
   2. Find all claims with date June 6, 2024 or later
   3. Click the invoice number
   4. Select services you want to send
   5. Click “Resend” button at bottom
   6. Click “Create” button to resend claim.

If your claims have already been transmitted, you may receive a denial from the payer for duplicate submission.

If you have any questions regarding this issue and what action you should take, please submit a support case through your portal.

I am acutely aware of the impact this can have on your organization, and I sincerely apologize for the disruption. We will provide an update as soon as this is resolved.

Regards,

Andrew Clement

VP, Customer Success

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Attention Procentive Customers: 

We appreciate your patience as we look into a matter that could potentially affect claims processing. Rest assured, our team is actively investigating to ensure minimal disruption. 

We'll provide another update by Monday, June 10th on this issue.

If you have any questions or concerns, please do not hesitate to contact our care team by submitting a case to Procentive through our Therapy Brands Community Portal.