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!

PER DHS:

I have reported a Connection Time Out error being returned for our Real Time application starting before 10 am CDT today.  Our Operations team is looking in to cause and a resolution.  No ETA at this time.

Eligibility though DHS is coming back with a Connection Time Out error for most users and DHS is working on a resolution. 

Please watch this post for updates as they become available!

We have been informed today by the clearinghouse that beginning with DOS 8/1/17, all claims for South Country Health Alliance sent an NPI number must also include the corresponding taxonomy code on the claims.

This means anywhere on your claim that there is an NPI (billing NPI, provider NPI) the corresponding taxonomy must also be sent.

Unfortunately, this is the first SHCA has notified the clearinghouse of the change and the clearinghouse suspects that there have already been denials for claims with DOS 8/1/17 and

forward. 

Please review this Knowledge Hub article to ensure your SCHA payer is setup correctly!

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

UPDATE:  The servers were successfully brought back online at 11:32 a.m. after Procentive identified an outage at 11:15 a.m.  The system operations team identified the problem and took action to confirm a solution and the system has been stable with no lingering effects.  On behalf of the Procentive team we apologize for the disruption this caused you this morning as you cared for your clients.  Our aim is to always seek to serve you as quickly as possible in any situation. Thank you for allowing us to partner with you in providing great care to your clients.

Pat Stream

Director of Customer Success

All claims being sent to MN MA (DHS) are coming back unacknowledged with a status of "No Response" in the Electronic Module. We are working to get in touch with DHS for more information and to find a resolution.

Please watch this post for updates. Thank you!

We have received the following notice from DHS:

All functions of MN–ITS will be unavailable from Saturday, August 5 at 6 a.m. until Monday, August 7 at 6 a.m.  while we do system maintenance. During this time all of MN–ITS will be unavailable, including:
•  All Direct Data Entry (DDE) transactions
•  All applications and systems that require users to log in to MN–ITS
•  All eligibility verification transactions, including phone verification
•  The MPSMISC file will not be available for uploads or downloads Batch transaction processing – All batch transactions will be unavailable, including secure FTP servers. You will not be able to submit any files during this time. (Pub. 7/22/17)

What does this mean for you?

Eligibility through Procentive will be unavailable during this time. This may also cause claims sent to MN MA (DHS) to fail.  All DHS systems (e.g. MN-ITS) will also be unavailable during this time.

We ask that you please wait to send claims to MN MA until their system is restored on Monday, August 7 at 6 AM. 

Please contact the Procentive Support Desk with any questions. Thank you!

We have received the following notice from DHS: 

All functions of MN–ITS will be unavailable from Saturday, July 22 at 6 a.m. until Monday, July 24 at 6 a.m. while we do system maintenance. This includes 270/271 Real Time X12.

What does this mean for you?

Eligibility through Procentive will be unavailable during this time. This may also cause claims sent to MN MA (DHS) to fail.

We ask that you please wait to send claims to MN MA until their system is restored on Monday, July 24 at 6 AM. 

Please contact the Procentive Support Desk with any questions. Thank you!