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 everyone! We just received the following email from the State of Minnesota regarding eligibility. Looks like their system will be down early on Monday morning until 8:00 a.m.

Date: Thu, Sep 29, 2016 at 7:49 AM

Subject: MN Medicaid Eligibility System Maintenance Downtime Monday, Oct. 3 from 5:30am - 8am CDT
To: Real Time Eligibility Users:

It has been brought to our attention that there was a change in the WI Medicaid portal that Procentive uses to submit and receive electronic claims. We are working with WI Medicaid to resolve the issue. For now, your electronic claims that are submitted will be returned with a "No Response" status. Once the issue is resolved, we will update this post.

In the Time Module, when you re-open an existing individual service line, the page is not loading correctly. Location, staff and other fields are displaying as none, even though the original data is saved correctly in the system. This is only a display issue. We are working to resolve this problem now and will update the system for everyone as soon as possible.

Issue: In the Time module, when entering service lines staff may receive pop up errors indicating that a rate could not be found. Assuming there is a rate entered for the code and payer, the service lines are saving correctly and errors are not appearing on the service line.

This issue is being worked on now and should be resolved shortly.

Procentive's KnowledgeHub (powered by MindTouch) is currently experiencing page loading issues.

The MindTouch Engineering team is currently investigating the issue causing our site to not load. We thank you for your patience during this time.

We have discovered a problem with the way Procentive is assigning diagnoses codes to group service lines. The system appears to be assigning DX codes incorrectly. We are still investigating the issue and working to resolve it as quickly as possible. We will post an update here as soon as the issue is resolved.

Codes are not displaying correctly when re-opening existing group service lines in the Time Module. The problem appears to be connected only to service lines that have an error. We are still investigating this issue in order to fully understand all that is happening. We hope to have a solution asap and will update this post as we learn more.

There is a potential issue in the Time/Add window with the Billing Supervisor field. The problem is only occurring for clients that have a billing supervisor setup in the clients module/staff tab. In this scenario, the billing supervisor that was selected in the client module/staff tab is not appearing as an option in the billing supervisor field in the Time/Add window.