We have tested sending and receiving in our own databases as well as checked into various customer databases. We do not see a system wide problem related to Procentive. It's possible there was a small issue earlier today somewhere in the faxing technology sending from specific payers, but this can't be verified. We've just recognized a commonality in a few things. Nevertheless, all issues seem to be resolved here at the end of the day. Thank you.
Schedule PMAP to become inactive/active?
Is it possible to schedule for a PMAP to become inactive at a certain date? We have a client who has BCBS PMAP through November, but is on straight MA as of 12/01/2017. We have several service lines to bill in November yet, which will be processed next week.
Since the new payer has been activated for 12/01/2017, is there a setting where I can tell Procentive to deactivate BCBS on 11/30/17 and have MA become active 12/01/2017? I'm just thinking that this would help eliminate rejected claims by associating new claims to an old payer.
I'm hoping this makes some sense...
Tracking units used
Hello,
I'm curious. My boss said we used to have Procentive track the number of units left for certain codes for patients.
Ex: We can bill 20 units of 90837 per year...this feature would track how many are used and give us a heads up if they were running out.
The only thing I've seen is the Benefits part which will show how many units are available for service with an authorization. Is this the only one or does my boss know of a magical new thing I should be utilizing?
KNOWN ISSUES: Resubmit claims sent last week
Last Tuesday there was coding related to an improvement to billing functionality that went through that triggered some claims to come back with an error from the clearing house. The error has been resolved on our end but claims sent Tuesday or Wednesday will need to be resubmitted.
Because of this we are making the following recommendations:
1. Review your Electronic Module for error-ed invoices that were sent on Tuesday or Wednesday and review the error reports.
2. The error is located in the H1 segment. If you find an error there, then the claim needs to be resubmitted. The error on our side has been resolved and the claim will go through without the error impacting the claim again.
3. Contact Procentive Support via the Ticketing Module if you have questions or concerns.
Fee schedule for UBH
Has anyone lately had trouble getting their new contracted rates updated in UBH's system. We have a contract effective 8/1/2017 and our claims still are not being paid correctly
UBH/Optum
Is anyone having trouble with UBH denying claims for no authorization when no authorization is needed?
BCBS Medicaid Overpayment
Has anyone else received their letter/invoice from BCBS in regards to the overpayment of Medicaid claims that were paid at a CMHC level, incorrectly? And is so, what is your plan to identify and "internally" re-process ALL of the affected claims?
Tracking clients insurance
How does your organization track which clients have had their insurance benefits verified versus those that have not been verified for outpatient appointments? (So all administrative staff can "see" this upon intake in procentive-specifically the Appointment Module)
E-Prescribing
Our agency is starting to use e-prescribing and have a few questions.
Does anyone use e-prescribing? How have you liked it? Are you able to prescribe C2 medications on Dr First? How does it work to send a lab order?
Thank you
Teresa
BCBS ERAs missing from the weekend?
Is anyone else missing ERA's from BCBS from this past weekend? I normally get some decent sized ERAs and have not yet received BCBS commercial and only a smaller than normal Blue Plus.
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