KNOWN ISSUES: Missing UHC/UBH ERAs

How will we know if our clinic is missing UHC/UCH ERA's? How was this found?

Be careful when posting. I am getting duplicate ERA's. The one I posted yesterday came thru as UMR. One came thru today as MA Medica. Same $ amounts but different ERA #s

After discussing this with the clearinghouse it has been determined that ERAs are not missing however, the information being transmitted does not match the payments. This makes it it very difficult (if not impossible) for you (our customers) to know that the correct ERAs have been received!

We are now in contact with the payer since this appears to be an issue on their end; the data they are sending to the clearinghouse is the same data that is entered into Procentive. We have opened a case with the payer and this is being further researched. Thank you for your patience!

Makes sense, here is a screen shot of my ERA module, the payer name coming in is not right, but when I got to save/create the payment, Procentive usually chooses the correct payer, ie Medica, United Healthcare, Medica PMAP. I figured it was just a glitch and didn't say anything. Would you like to know this information when we see it so you can get things fixed? And would you like it in a ticket?

Thank you for this additional information, Crystal! I will reach out to you in a ticket so I can get more details from you.

We have been in touch with both UHC and the clearinghouse trying to push them along in resolving this issue however, they are both still researching this and trying to find a solution. It cannot be confirmed that ERAs have been received in Procentive, that is just what their research is showing at this time.

If you would like to post your payments while this is being researched, it will need to be done manually by obtaining the EOBs from the Optum web portal. From speaking with UHC we have been informed that these EOBs should be available for you. Once we have a resolution to the issue we will help resolve any duplicate payments if they arise.

We understand how frustrating this has become and really appreciate you working with us while this is resolved.

If you could relay this to UBH/UBC/Optum, I'm not able to obtain the ERA's to even enter manually through their OPTUM EPS portal.

This error below shows up when selecting "Download 835"

This error below shows up when clicking "Print Available"

For the missing ERAs, the money should be in your bank account but that is something you will have to verify with your financial institution. The correct payment amount with the correct ERA may or may not be in Procentive - this is something we're still trying to determine.

Unfortunately, this problem is between UHC and the clearinghouse and they've not been able to offer a time frame for a resolution - they're still not even certain what the cause of the problem is. We know this is a frustrating issue and we were hoping for a quicker, easier solution but since we still don't have an answer we're suggesting the alternative of manually posting payments.

It has been confirmed by a few customers that they have been able to get their EOBs from the Optum web portal. If you experience an issue obtaining your EOBs online, please contact Optum at the number listed.

Should any duplicate payments arise because of this, we will help you get them resolved.

Thank you all for your patience and understanding during this difficult situation, it's greatly appreciated.

The clearinghouse has updated us that they are still working with UHC to find the issue and resolve it. Once we've reached a solution to this our hope is that all of the missing ERAs will be available for you in Procentive but we still do not have a time frame on this.

If you are still not receiving ERAs from any UHC payers and would like the payments posted in Procentive they will need to be manually posted due to the unique nature of this situation.

We have received another update from the clearinghouse today and unfortunately the clearinghouse and UHC are still not able to determine any errors. They currently believe that all ERAs are being received by you, our customers, and have chosen to close this case.

Since the clearinghouse is unable to provide us with the missing ERAs up to this point we will need you to manually post any payments that did not come through the ERA module. These EOBs can be obtained via the Optum web portal.

If you are not receiving ERAs for payments dated 03/13/2017 or after, please send a ticket to the Support Desk with the following information so that we can open a new case.

Thank you!

Information to include in a ticket for missing UHC ERAs:

NPI & TIN payment was made to

Check #

Check Amount (must be greater than $0)

Check Date (must be 3/13/17 or later)

Anyone know if Medica PMAP ERA's have been missing? I found on Provider Express under EPS where I can view payments, however, I know the PMAP ones are not on here. Are there other sites I need to look into to make sure I'm finding all payments/remits. We all know there are many parts to the Optum/Medica/UHC/UHB family so looking on one site for payments I know does not cover my bases.

We actually found some that we couldn't previously find and never showed up on remits on Optum Financial today. Might be worth a try!

I find everything Optum on this site: https://myservices.optumhealthpaymentservices.com

Is anyone else not receiving UBH/Medica ERA's again?

Yes. We did not receive UBH/Medica ERA's on 3/7/17 and 3/9/17.

I just received 6 missing ERA's from UHC that covered dates in February and March.

I already manually posted them.

tbrault - I received the same in our ERA system. I too manually posted the payments for covered dates Feb/Mar. You're not alone on this journey.

I also received 5 different ERA's from late February/ early March that I've already posted manually. :)

When this happens to us, I just verify the information was received and recorded manually and then check the "processed" box in the ERA module without creating the payment again. There may be alternate methods, but this one works well for us.

Make sure you all check January ERA's. I found 2 missing ERA's and I also had to post them manually.

I received 3 decent sized ERA's on April 4 that were dated for Feb and March, so apparently they were missing and just got to me. I'm not sure how UHC and the clearing house closed the case thinking that there were no ERAs missing, when I gave specific examples to Procentiv to pass along to them. Today, I got a HRA check for a client but I have not yet received a ERA showing how this DOS processed so again, we are missing/not receiving ERAs in a timely manner. This is frustrating as I don't really 'know' we are missing ERAs until something like this happens...where we get a HRA payment bc its processed through insurance and passed on to HRA account, but yet we don't have the remittance showing how it processed.

We only received 2 ERAs out of 12 so far for April. I've been cross checking what we get through Procentive and what is on the OPTUM EPS site. I've been posting manually the ERAs. I did send a help ticket with the information.

We have not received any UHC ERAs from Procentive in April. I've retrieved 3 from the OPTUM EPS site today.

I got a bunch of Medica/UHC ERA's last week as well that were dated earlier. Please tell the clearing house and Medica that they are still having issues.