Ucare requiring Value 24 Codes to Residential Claims

Morgan Kluender 2 years ago in Billing/Electronic Modules updated by Alicia O 2 years ago 6

Ucare is denying Residential claims due to no Value 24 Code being listed on the claim. After speaking with Ucare, a number of times, we are continually hearing that V24 code has to be in box 39 on the UB-04 claim. Is anyone else being told this? 

Procentive is telling us that V24 codes can only go out on MA claims. 

Are we alone in this issue? 

Our claims are being paid but not at the correct rate. They tried to tell me the value code 24 code was needed also. I'm only seeing an option for that code on MA claims also. 

You are not alone!

Hello, we have claims not being paid correctly also but have not been given a clear explanation as to why.  This may explain it.  

They also have not paid for any of our 2022 services as of now.  

They are trying to say that we need the value 24 code, which seems ridiculous. I am working with someone there who is reaching out to her manager to voice my concern. 

We also had a stall out in reimbursement; the Ucare system update caused a lot of hiccups and claims to be reprocessed.  I recommend reaching out to the UCare contract manager at DHS, Allison Rose 651-431-5580. She was helpful for us. And that way DHS can trend payer issues. 

Our claims are processing at the non-enhanced rate with UCare, however to get the enhanced rate Ucare is stating they are requiring a Value 24 code. When I reached out to Procentive, they informed me that Procentive is only set up to have Value 24 codes for MA. I have a ticket in, and am waiting for a response. 

Thank you for the update. If they want the Value 24 code and Procentive is able to add that for Ucare EDI claims, it's doable but no other PMAP requires this. The other payers reach out to the MMIS provider file for a match and process based on that. 

I appreciate the collaboration from you all!

Since Procentive made the update to the UCare payer to allow the value code 24 to travel on the claim we've noticed a significant slow down in payments on the claims that include it.  Has anyone else seen the same?  Previous to this change we were getting payments within 1-2 weeks (at the wrong rate), now we are seeing nothing on the claims that include the value code when they would have paid by now if they were following the previous schedule.

We are still seeing OP and other claims billed without the value code paying in 1-2 weeks.  We've attempted to contact our contract rep several times, but have not been able to get a response yet.