Revenue Management and UHC

[ndewitt]

When I submit claims through Revenue Management, the CHECK CLAIMS is clean, but when I SEND CLAIMS, my United Healthcare Claims freeze the batch process of sending. I have tried removing the claim that it freezes on and it will then freeze at the next UHC. Once all UHC claims are not in the batch, it checks and sends without problem.

Is there something that has changed in Revenue Management with UHC?

[Gavin Walker]

You'll have to look at the cryptic message and see what is causing the error. The most common error here is the insurance is missing the claims payer id on the EDI tab. Did someone setup another UHC insurance carrier record in Medisoft and forget to enter this in? Also, there is the option to remove all failed claims, so you don't have to do these 1 at a time.

[ndewitt]

I had CPID 3429 on some UHC insurances and some had Payer ID 87726. Nothing has changed since my last successful batch of claims 2/18/22. Which ID is recommended, CPID or Payer ID? I usually go with the Payer ID on the card. How do I remove failed claims to get these to process?

Nancy

[ndewitt]

I had CPID 3429 on some UHC insurances and some had Payer ID 87726. Nothing has changed since my last successful batch of claims 2/18/22. Which ID is recommended, CPID or Payer ID? I usually go with the Payer ID on the card. How do I remove failed claims to get these to process? There are no errors that come up. Check claims comes back clean. It just freezes on the first UHC claim while "Building Claims" is running after I hit SEND claims.

Nancy

[Gavin Walker]

You need to look and see which is THE UHC insurance carrier for the claim and what claims payer id is setup on that. Also could be a secondary id. Also, we still don't know what the error message is. That should narrow down a lot where to go to fix the error. What clearinghouse do you use?

[ndewitt]

I use Relay Health/Change Healthcare set up through you. I made sure the name is UHC and the payer ID is 3429. i even tried switching it to 87726.
It continues to freeze on the first UHC claim that tries to send. There is no error message. It just freezes on the UHC claim number while Building Claims batch to send. I have left 2 messages for help on your customer service line.

[Gavin Walker]

Hi Nancy, on your case you had provider code "3" but there was no such code in your database. When you created the claim, provider "3" carried to the claim. When Revenue Management tried to process that claim, it simply hung because there is not provider "3" in your database. Not sure how this happened because you are not supposed to be able to enter a provider code that is not in your database, so somehow the provider record was removed AFTER your case was setup with the provider. When I changed the provider code to one that was setup in your database, then the claim submitted just fine to Change Healthcare. Please let us know if you need anything else.