I recently read something in one of the payer manuals that said they still want claims sent to them if they are the secondary payer even if we know they would not pay because there was no CCD left from primary payer. What is your billing practice? If there is no CCD or PR left from how the primary payer processed and paid do you still submit claims to the secondary (whether its commercial or MA)?

Is anyone else having issues with Availity-specifically with UCare?  I have an entire invoice that was never received by UCare and I have verified eligibility, credentialing and everything else I can think of, resubmitted the entire invoice both in entirety and also in several smaller invoices (client by client) and the information is just not reaching UCare.  Also, the interest isn't carrying over on my ERA's, when I actually get them.  So far I have had 4 ERA's this year that were never loaded into Procentive and I am getting frustrated.  A representative at UCare just told me about a clearinghouse called MN E-Connect.  Thoughts?  Suggestions? 

Anyone else missing diagnosis's and admission information for all clients? 

Is anyone else experiencing lagging today? Searching for clients and changing workflow projects are two things that are really moving slowly. I have gotten reports from our providers in different areas, too - so I know it isn't an internet issue.

Chris

Procentive has been informed by the clearinghouse that no ERAs have been received from Unity Healthcare (ID 66705) since February 23. The clearinghouse is working with the payer to resolve the issue and ensure ERAs are delivered. 

We will update this post once the issue has been resolved.

Thank you!

Does anyone know how to enter the Benefit Begin date for Medicare subscribers?  When an eligibility check is run in Procentive, we see the Medicare number and Benefit Begin date at the bottom of each eligibility check.  When adding Medicare to a client profile, there is no Benefit Begin date field to enter this in.  However, there is a "Retirement Date."  Is the Benefit Begin & Retirement Date the same thing?

Thanks!

Hello all!

I am having issues with one specific client who has a UHC private and DHS secondary. We are billing IOP services. The UHC denied for medical necessity up front but since DHS covers our services, we figured they would just be billed as secondary, especially since we had that physical denial.

The EOB's have been coming back from UHC stating "contractual obligation" instead of "patient responsibility." Due to this, secondary will not pay.

Has anyone else had this issue? Do you have any solutions?

We are unable to access tickets in the Ticketing Module. I don't know if this is just our account, or all accounts. One of my clinicians emailed me about the issue, and then I tried and found I was unable to access tickets as well. I was thinking this community posting would be better than sending a ticket, in case it is system-wide. I will try sending a ticket as well, just in case.

Hi - We are beginning to prepare to change our Procentive form for our Diagnostic Assessment for the Extended DC 0-5 format.  Wondering if any other members are already on this/have created it or if they are interested in working together to create something for Axis 1-5 for the DC 0-5 in Procentive that would be helpful? 

Reply here or contact me via email:  jjudisch@thevillagefamily.org

Thanks!

I know people are having problems with the eligibility module, but is anyone having issues with every module?  My billing module isn't working.  I am getting complaints from staff that the clinical module is having problems.  This is the big day of the month to do facility billing and we are stuck.