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Availity

Andrea Drews 2 years ago in Payments/ERA Modules updated by dianef 2 years ago 4

Is anyone else having issues with Availity-specifically with UCare?  I have an entire invoice that was never received by UCare and I have verified eligibility, credentialing and everything else I can think of, resubmitted the entire invoice both in entirety and also in several smaller invoices (client by client) and the information is just not reaching UCare.  Also, the interest isn't carrying over on my ERA's, when I actually get them.  So far I have had 4 ERA's this year that were never loaded into Procentive and I am getting frustrated.  A representative at UCare just told me about a clearinghouse called MN E-Connect.  Thoughts?  Suggestions? 

Hi Andrea,

Have you gone into your electronic module in procentive to see if there were any errors/rejections with the claims?

The electronic report shows claims accepted by UCare.  When I call UCare with the repository number they tell me it is invalid.

Yes, I had a couple claims that never made it to UCare and when I called them just yesterday, they stated that the client I was submitting for is on Connect Plus Medicare and that is a new extension for his funding that they cover and she will call me back when we are approved. There is no credentialing for this Connect Plus Medicare, you just call them and they get your facility/facilities approved and will call you back. When I asked why I didn't get a letter or an update for this branch of coverage, she had no answer. So you may want to call and ask what Group the client is under. Hope that helps Andrea : ) 

We have had huge issues with the UCare Connect Plus Medicare product. We have a long-term, seriously ill client who has always had Medicare and Ucare. The clinician has always been credentialed with Medicare and with UCare. They don't automatically make therapists credentialed for this newer product (the Connect Plus Medicare began in April of 2017). It has taken 5 months to get them to admit that they have processed the credentialing application and the request for retro coverage wrong---with a client bill mounting to over $2000 while they kept telling us the clinician was now credentialed. Don't let them refuse you.We are getting every cent, but it's been a battle.