Katie Scharberg 4 months ago in Billing/Electronic Modules updated by John-Debbie Trunk 4 months ago 1

Is anyone else noticing a huge influx of rejections within the Electronics module? We would rarely get rejections and now it seems like I can hardly keep up and I have no idea what the issues are. I understand the issue with Blue Plus does not help but I am also seeing other payers rejecting and I'm wondering if there is an issue within Availity? I have created tickets for help but that seems to be taking foreverrrrrr. Example of a rejection - billing UMR for a client we have received payments previously and it appears most of the client claims are being accepted but a couple random ones are rejecting stating  "Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system. Status: Subscriber and policy number/contract number not found." Just feels like i'm going in circles in the electronics module.... Can anyone relate? Or help?? 

Yes. We are experiencing an uptick in rejections. Nothing with the rendering provider has changed from 2023 to 2024. The rejections don't make any sense. I've sent PRO a help ticket but with no resolution yet.