Has anyone been having issues with UCare claims for outpatient substance use disorder? We have been struggling with this issue since Oct. 2016 and UCare doesn't have any answers for us for this main reason: claims continue to reject and don't even reach UCare. I've tried sending claims on both UB04 and CMS 1500 forms, I've changed the "Facility" under the client's Admissions tab from "13" to "89", and I've made sure to include both taxonomy codes (even though the first claims were sent before this was a requirement in March 2017)...I'm feeling at a loss of what to do now as we didn't have these issues prior to Oct. 2016. We don't encounter UCare much, but now I have two more clients with UCare who are starting services. Any advice?
P.S. The following is the error/rejection message I get from Procentive in the X12 Claim Data:
Message Text:Category: Acknowledgement/Returned as unprocessable claim The Claim/Encounter has been rejected and has not been entered into the adjudication system Status: Processed according to contract provisions (Contract refers to provision that exist between the Health Plan and a Provider of Health Care Services)
Customer support service by UserEcho