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ProviderOne Discovery Log

Discovery Log: Open

Discovery Log Number

00352

Discovery Description

Due to the timing of the State Fiscal Year End and the observance of Independence Day, payments to providers for the week of June 28, 2021, will be made on Wednesday, July 7, 2021. Remittance Advices (RAs) and HIPAA 835 payment files will also be made available on Wednesday, July 7, 2021.  Normally payments and remittance advices would be available for providers on Friday, July 2, 2021.

 

Claim submission deadlines have been updated as reflected below to ensure that providers are able to receive payment and Remittance Advice documents on July 7, 2021.

 

The deadline for submission of claims to ProviderOne in order to receive payment on July 7, 2021 will be 4 p.m. on Thursday, July 1, 2021.

 

The deadline for submission of pharmacy claims to the Point of Sale (POS) in order to receive payment on July 7, 2021 will be 6 p.m. on Wednesday, June 30, 2021.

Date Reported

6/14/2021

ETA

7/8/2021

Provider Impact

All Providers

Workaround

Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

7/8/2021

Discovery Log Number

00351

Discovery Description

For OPPS claims with a payment date of 07/01/2020, in addition to incorrectly paying the claims at 0.00, several erroneous EAPG errors were returned

Impact to clients, provider or staff: Claims were not paid correctly

Date Reported

5/6/2021

ETA

8/30/2021

Provider Impact

Phase 1

Workaround

These errors have been fixed. For adjustments, the providers can submit the claim numbers on an excel spreadsheet to claimerror@hca.wa.gov

Date Closed

8/31/2021

Discovery Log Number

00350

Discovery Description

When adding a new servicing provider (step 14), additional information will need to be indicated: Agency, Taxonomy and Location.

Billing providers will be able to associate their servicing providers to a specific servicing location.

Billing providers will be able to associate taxonomies to a specific servicing location.

A resource document for making changes to the provider file will be available soon.

The location information will improve the accuracy of online tools to assist clients in finding available medical providers.

The Provider Roster spreadsheet has been modified to include these 3 new elements: Location, Agency and Taxonomy.

These changes meet March 2021 CMS rule and provision to make provider directory information publicly available via a standards-based Application Programming Interface (API).

Date Reported

5/4/2021

ETA

9/30/2021

Provider Impact

All Providers

Workaround

N/A

Date Closed

10/1/2021

Discovery Log Number

00349

Discovery Description

Due to a system issue involving the inpatient grouping software that is still being tracked, some inpatient claims received by HCA may either improperly fail to group to a DRG, causing a denial, or in a smaller number of cases, group to an incorrect DRG, which may cause some denials or pricing changes. The issue will be resolved as quickly as possible.

In most cases involving this issue, providers will see inpatient claims deny for failure to group to a DRG. In a minority of cases, there may be some claims which group to an incorrect DRG.

Date Reported

4/30/2021

ETA

12/31/2999

Provider Impact

Phase 1

Workaround

Follow established processes for checking into claims denials through customer service phone or email. Alternatively, the user may attempt to adjust claims themselves as most claims group correctly on the second attempt.

Date Closed

N/A

Discovery Log Number

00348

Discovery Description

When adding a new user account to ProviderOne, the EID field is only allowing numeric characters and should be allowing alphanumeric characters.

Date Reported

4/5/2021

ETA

6/25/2021

Provider Impact

All Providers

Workaround

After the new user is created, access the users ‘User Details’ screen, update the EID field with the alphanumeric characters and save.

Date Closed

6/26/2021

Discovery Log Number

00270

Discovery Description

This issue is not specific to ProviderOne. Please refer to the Adobe website for assistance.

ProviderOne related issue: When creating barcode coversheets using come internet browsers, the barcode is not generating/displaying.

Date Reported

5/5/2017

ETA

12/31/2999

Provider Impact

All Providers

Workaround

Use Internet Explorer to generate barcode coversheets.

Date Closed

12/31/2999

Discovery Log: Closed

Discovery Log Number

00353

Discovery Description

Due to an unexpected issue, the outage planned from June 12, 2021 has been cancelled.  Future communication will be sent regarding when this outage will occur.  The ProviderOne system will be fully functional and available Saturday, June 12, 2021.

Date Reported

6/11/2021

ETA

6/13/2021

Provider Impact

All Providers

Workaround

Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

6/13/2021

Discovery Log Number

00352

Discovery Description

The ProviderOne system will be unavailable Saturday, June 12, 2021 from 6 a.m. until 4:30 p.m. (10.5 hours) due to scheduled maintenance.

 

This outage does not affect the Pharmacy POS

Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete.

Date Reported

6/4/2021

ETA

6/12/2021

Provider Impact

All Providers

Workaround

Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

6/11/2021

Discovery Log Number

00347

Discovery Description

The ProviderOne system will be unavailable Saturday, March 20, 2021 from 6 a.m. until 5:30 p.m. (11.5 hours) due to scheduled maintenance.

 

This outage does not affect the Pharmacy POS

Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete.

Date Reported

3/11/2021

ETA

3/20/2021

Provider Impact

All Providers

Workaround

Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

3/21/2021

Discovery Log Number

00346

Discovery Description

The ProviderOne system will be unavailable from 3 a.m. Saturday, February 20 until 9 p.m. Sunday, February 21 (42 hours) due to scheduled maintenance.

 

This outage does not affect the Pharmacy POS

Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete.

Date Reported

2/12/2021

ETA

2/21/2021

Provider Impact

All Providers

Workaround

Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

2/22/2021

Discovery Log Number

00345

Discovery Description

Providers are signing into the Portal and can't access their closed domains as they are not listed as one of the Provider IDs.

Currently Providers will not be able to access their closed domains on the Portal until after this defect goes into production.

Date Reported

2/8/2021

ETA

4/21/2021

Provider Impact

All Providers

Workaround

Providers can call Provider Enrollment or email them at providerenrollment@hca.wa.gov if it is an emergent situation.

Date Closed

4/22/2021

Discovery Log Number

00344

Discovery Description

Christmas and New Year’s holiday will impact ProviderOne payment dates and claim submission deadlines

The observance of both Christmas and New Year’s holidays will result in changes to the ProviderOne payment dates and claim submission deadlines for both holiday weeks.

Christmas payment date and submission deadline change:
In observance of Christmas, state offices will be closed Friday, December 25, 2020. As a result, provider payments for the week of December 21 will be made on Thursday, December 24, including the delivery of Remittance Advices (RAs) and HIPAA 835 remittance files.

Claim submission deadlines have been moved up to ensure that providers are able to receive payment and RA documents on December 24.

- The deadline for submission of claims to ProviderOne for payment during the week of Christmas will be Monday, December 21 by 4 p.m.

- The deadline for submission of pharmacy claims to the Point of Sale (POS) during the week of Christmas will be Sunday, December 20 by 4 p.m.

New Year’s payment date and submission deadline change:
In observance of New Year’s Day, state offices will be closed Friday, January 1, 2021. As a result, provider payments for the week of December 28, 2020 will be made on Thursday, December 31, 2020, including the delivery of RAs and HIPAA 835 remittance files.

Claim submission deadlines have been moved up to ensure that providers are able to receive payment and RA documents on December 31.

- The deadline for submission of claims to ProviderOne for payment during the week of New Year’s will be Monday, December 28 by 4 p.m.

- The deadline for submission of pharmacy claims to the Point of Sale (POS) during the week of New Year’s will be Sunday, December 27 by 4 p.m.

Date Reported

12/10/2020

ETA

12/31/2020

Provider Impact

All Providers

Workaround

Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

N/A

Discovery Log Number

00343

Discovery Description

The ProviderOne system will be unavailable from 4 a.m. Saturday, December 12 until 9 a.m. Sunday, December 13 (29 hours) due to scheduled maintenance.

This outage does not affect the Pharmacy POS
Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete.

Date Reported

12/4/2020

ETA

12/14/2020

Provider Impact

All Providers

Workaround

Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

N/A

Discovery Log Number

00342

Discovery Description

UPDATE 12/4/20: Due to system constraints, ProviderOne cannot offset the payments on the remittance advice due to a switch in payment from agencies. This will look like the provider has been paid twice for the services, but it is creating a receivable in OFR for the overpayment. OFR will reach out to providers to collect the overpayment. PROVIDER IMPACT: Over 40K Nursing Home claims were paid out of the incorrect account code program. Claims affected have payment dates between Sept 18 and November 13. The adjustments will correct the account coding. ORIGINAL ISSUE 11/18/20: Over 40K Nursing Home claims were paid out of the incorrect account code program. Claims affected have payment dates between Sept 18 and November 13. The adjustments will correct the account coding.
No impact to staff or clients. Providers will see a claim increase in the Adjustment area of their Remittance Advice. The adjustments should not affect the payment amount.

Date Reported

11/18/2020

ETA

1/31/2021

Provider Impact

Phase 1

Workaround

No workaround needed/necessary

Date Closed

N/A

Discovery Log Number

00341

Discovery Description

There was an issue with units on EPA causing claims to deny for units billed being greater than the authorized units available. Claims were denied erroneously and will be reprocessed with a mass adjustment

Date Reported

11/12/2020

ETA

12/3/2020

Provider Impact

Phase 1

Workaround

There is no workaround. The issue is now fixed and claims will be adjusted by state staff

Date Closed

N/A

Discovery Log Number

00340

Discovery Description

In observance of Thanksgiving, state offices will be closed Thursday, November 26, 2020 and Friday, November 27, 2020. As a result, provider payments for the week of November 23, 2020 will be made on Wednesday, November 25, 2020, including the delivery of Remittance Advices (RAs) and HIPAA 835 remittance files.

Date Reported

11/9/2020

ETA

11/30/2020

Provider Impact

All Providers

Workaround

Claim submission deadlines have been moved up to ensure that providers are able to receive payment and RA documents on November 25, 2020. The deadline for submission of claims to ProviderOne for payment during the week of Thanksgiving will be Sunday, November 22, 2020 by 4 p.m.. The deadline for submission of pharmacy claims to the Point of Sale (POS) during the week of Thanksgiving will be Saturday, November 21, 2020 by 4 p.m..

Date Closed

N/A

Discovery Log Number

00339

Discovery Description

Due to the observance of Veterans Day (November 11), ProviderOne claims submission deadlines have been moved up to ensure that providers are able to receive payment and Remittance Advices (RAs) and HIPAA 835 files on Friday November 13, 2020.

The deadline for submission of claims to ProviderOne for payment during the week of Veterans Day will be 4 p.m., Monday November 9, 2020.

Date Reported

10/26/2020

ETA

11/9/2020

Provider Impact

All Providers

Workaround

The deadline for submission of pharmacy claims to the Point of Sale (POS) for payment during the week of Veterans Day will be 4 p.m., Sunday November 8, 2020.

Date Closed

N/A

Discovery Log Number

00338

Discovery Description

The ProviderOne system will be unavailable from 3 a.m. Saturday, October 10 until 7 p.m. Sunday, October 11 (40 hours) due to scheduled maintenance.

Date Reported

10/1/2020

ETA

10/11/2020

Provider Impact

All Providers

Workaround

This outage does not affect the Pharmacy POS Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete. Please report any issues to: mmishelp@hca.wa.gov

Date Closed

N/A

Discovery Log Number

00337

Discovery Description

The ProviderOne system will be unavailable Saturday September 12, 2020 from 6 a.m. until 7 p.m. (13 hours) due to scheduled maintenance.

Date Reported

9/3/2020

ETA

9/13/2020

Provider Impact

All Providers

Workaround

This outage does not affect the Pharmacy POS Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete.

Date Closed

N/A

Discovery Log Number

00336

Discovery Description

Institutional status in client file incorrectly suspending some Nursing Home claims slowing down processing time.

Date Reported

7/29/2020

ETA

8/1/2020

Provider Impact

Phase 1

Workaround

There is no work around. Claims Processing will review the suspended claims and force through for payment as needed.

Date Closed

8/1/2020

Discovery Log Number

00335

Discovery Description

The ProviderOne system will be unavailable from 3 a.m. Saturday, July 11 until 6 p.m. Sunday, July 12 (39 hours) due to scheduled maintenance.

Date Reported

7/2/2020

ETA

7/13/2020

Provider Impact

All Providers

Workaround

This outage does not affect the Pharmacy POS Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete. Please report any issues to: mmishelp@hca.wa.gov

Date Closed

N/A

Discovery Log Number

00334

Discovery Description

Due to the observance of Independence Day, provider payments for the week of June 29, 2020 will be impacted.

Date Reported

6/8/2020

ETA

7/2/2020

Provider Impact

All Providers

Workaround

Provider payments for the week of June 29, 2020 will be made on Tuesday, July 7, 2020, including the delivery of Remittance Advices (RAs) and HIPAA 835 remittance files. Claim submission deadlines have been extended for the week of June 29, 2020. • The deadline for submission of claims to ProviderOne for payment will be Wednesday July 1, 2020 by 4 p.m. • The deadline for submission of pharmacy claims to the Point of Sale (POS) for payment will be Tuesday, June 30, 2020 by 4 p.m.

Date Closed

7/2/2020

Discovery Log Number

00333

Discovery Description

The ProviderOne system will be unavailable Saturday, June 13, 2020 from 6 a.m. until 6 p.m. (12 hours) due to scheduled maintenance.

Date Reported

6/5/2020

ETA

6/13/2020

Provider Impact

All Providers

Workaround

This outage does not affect the Pharmacy POS Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete. Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

6/14/2020

Discovery Log Number

00332

Discovery Description

Currently when Provider rosters are being uploaded and DEA and License dates are outside of the business status start dates the system is throwing errors 5082 and 5083. This defect will be removing these errors and excepting dates outside of the enrollment dates.

Date Reported

4/6/2020

ETA

7/24/2020

Provider Impact

All Providers

Workaround

Currently staff and providers will need to keep the DEA and license dates in the same start date of the enrollment of the provider on the Roster.

Date Closed

N/A

Discovery Log Number

00331

Discovery Description

The ProviderOne system will be unavailable from 3 a.m. Saturday, April 11 until 6 p.m. Sunday, April 12 (39 hours) due to scheduled maintenance.

Date Reported

4/3/2020

ETA

4/13/2020

Provider Impact

All Providers

Workaround

This outage does not affect the Pharmacy POS Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete. Please report any issues to: mmishelp@hca.wa.gov

Date Closed

N/A

Discovery Log Number

00330

Discovery Description

The ProviderOne system will be unavailable Saturday, March 14, 2020 from 6 a.m. until 5 p.m. (11 hours) due to scheduled maintenance.

Date Reported

3/6/2020

ETA

3/15/2020

Provider Impact

All Providers

Workaround

This outage does not affect the Pharmacy POS Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete. Please report any issues to: mmishelp@hca.wa.gov

Date Closed

3/15/2020

Discovery Log Number

00329

Discovery Description

When a HCA provider is enrolled under Tribal Health and they go into Step 15 to add servicing providers the Add button is greyed out.

Date Reported

2/3/2020

ETA

4/3/2020

Provider Impact

Phase 1

Workaround

Provider Enrollment staff can go into the servicing provider domain and add these to their Billing Provider step which then will associate to the Tribal Health domain.

Date Closed

N/A

Discovery Log Number

00328

Discovery Description

The observance of the Christmas and New Year holidays will result in a shift to the deadline for submitting claims for processing. The claims submission deadline will be moved up one day to facilitate and ensure provider payments for both holiday weeks are not delayed.
Christmas submission deadline change:
The deadline for submission of claims to ProviderOne for payment during the week of Christmas will be Monday, December 23, 2019 by 4 p.m.
The deadline for submission of pharmacy claims to the Point of Sale (POS) during the week of Christmas will be Sunday, December 22, 2019 by 6 p.m.
New Year submission deadline change:
The deadline for submission of claims to ProviderOne for payment during the week of New Year’s Day will be Monday, December 30, 2019 by 4 p.m.
The deadline for submission of pharmacy claims to the Point of Sale (POS) during the week of New Year’s Day will be Sunday, December 29, 2019 by 6 p.m.

Date Reported

12/11/2019

ETA

12/30/2019

Provider Impact

All Providers

Workaround

Date Closed

N/A

Discovery Log Number

00327

Discovery Description

In observance of Thanksgiving, state offices will be closed Thursday, November 28, 2019 and Friday, November 29, 2019. As a result, provider payments for the week of November 25, 2019 will be made on Wednesday, November 27, 2019, including the delivery of Remittance Advices (RAs) and HIPAA 835 remittance files.
Claim submission deadlines have been moved up to ensure that providers are able to receive payment and RA documents on November 27, 2019.
• The deadline for submission of claims to ProviderOne for payment during the week of Thanksgiving will be Sunday, November 24, 2019 by 4 p.m.
• The deadline for submission of pharmacy claims to the Point of Sale (POS) during the week of Thanksgiving will be Saturday, November 23, 2019 by 6 p.m.

Date Reported

11/12/2019

ETA

11/25/2019

Provider Impact

All Providers

Workaround

Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

N/A

Discovery Log Number

00326

Discovery Description

The ProviderOne system will be unavailable from 3 a.m. Saturday, November 9 until 9 a.m. Sunday, November 10 (30 hours) due to scheduled maintenance.

This outage does not affect the Pharmacy POS
Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete.

Date Reported

11/1/2019

ETA

11/11/2019

Provider Impact

All Providers

Workaround

Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

N/A

Discovery Log Number

00325

Discovery Description

The ProviderOne system will be unavailable from 3 p.m. Saturday, October 12 until 8:30 a.m. Sunday, October 13 (17.5 hours) due to scheduled maintenance.

Date Reported

10/7/2019

ETA

10/14/2019

Provider Impact

All Providers

Workaround

This outage does not affect the Pharmacy POS Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. The faxes will be processed after the outage is complete. Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

N/A

Discovery Log Number

00324

Discovery Description

There is one Provider Roster spreadsheet that was determined by the agency to be used. If a provider uploads an incorrect formatted spreadsheet it could seem to have been accepted by the system, but staff will have to reject it. Please make sure and use the Agency specific Provider Roster spreadsheet.

Date Reported

9/9/2019

ETA

12/13/2019

Provider Impact

All Providers

Workaround

System will allow the Provider to upload an incorrect formatted spreadsheet, but then it will have to be rejected.

Date Closed

N/A

Discovery Log Number

00323

Discovery Description

Codes D2390, D2932, D2933, and D2934 were erroneously updated to require Prior Authorization. This has been corrected in the system. A mass adjustment has been submitted to correct the claims.

Claims for these codes have denied for 'No Prior Authorization'. These claims will be adjusted and paid to providers.

Date Reported

8/14/2019

ETA

8/23/2019

Provider Impact

Phase 1

Workaround

Date Closed

N/A

Discovery Log Number

00322

Discovery Description

Claims that should be paying at PAC DMEPOS are paying at MAXNONFAC-Maximum Non-Facility Amount instead. This issue started after our last release, claims with paid dates after 07/05/19, and is scheduled to be corrected in our next release on 08/23/19.

Date Reported

8/12/2019

ETA

8/23/2019

Provider Impact

Workaround

Once the issue has been corrected, claims will be identified, and a mass adjustment will be done to update the affected claims.

Date Closed

N/A

Discovery Log Number

00321

Discovery Description

There are Apple Health (Medicaid) clients, whose claims have been denied because of a Managed Care Plan's recoupment (due to Medicare/Retro Medicare eligibility).

There is an impact to Providers. Premiums that have been paid to Managed Care Plans have been recouped, due to Medicare/Retro Medicare eligibility updated within ProviderOne.

Date Reported

7/24/2019

ETA

1/23/2020

Provider Impact

Phase 1

Workaround

Providers will need to submit claims to Medicare for reimbursement, if applicable, and those claims should crossover to ProviderOne for additional payment. If Medicare does not cover the specific service, then Providers will need to submit those claims directly to ProviderOne for payment. When submitting a claim for payment consideration, please add the following claim note to your claims submission: MC RECOUP DATED [MM/DD/YYY] When the claim is submitted/resubmitted, it may be denied for timely filing and you must contact the Health Care Authority (1-800-562-3022) with the claim/TCN numbers to be reprocessed. Once the claim has been submitted please do not resubmit your request until you receive final determiantion on your Remittance Advice and/or 835. If you do resubmit before finalization of the claim, the claim will automatically deny as a duplicate.

Date Closed

N/A

Discovery Log Number

00320

Discovery Description

When uploading a provider roster for SSSO providers and the billing provider has multiple locations for SSL system didn't know which location to add these providers to.

When using the Roster for Social Service Servicing Only providers to a billing provider with multiple locations the system will only load to one of the locations.

Date Reported

7/16/2019

ETA

10/21/2019

Provider Impact

All Providers

Workaround

When using the Roster for Social Service Servicing Only providers to a billing provider with multiple locations the system will only load to one of the locations.

Date Closed

N/A

Discovery Log Number

00319

Discovery Description

The ProviderOne system will be unavailable from 3 a.m. Saturday, July 13 until 3 p.m. Sunday, July 14 (36 hours) due to scheduled maintenance.

Date Reported

7/9/2019

ETA

7/15/2019

Provider Impact

All Providers

Workaround

This outage does not affect the Pharmacy POS Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete.

Date Closed

N/A

Discovery Log Number

00318

Discovery Description

In observance of Independence Day, State offices will be closed Thursday, July 4, 2019. As a result, provider payments for the weeks of June 24, 2019 and July 1, 2019 will be impacted.

Provider payments for the week of June 24, 2019 will be made on Thursday, June 27, 2019, including the delivery of Remittance Advices (RAs) and HIPAA 835 remittance files.

Claim submission deadlines have been moved up to ensure that providers are able to receive payment and RA documents on Thursday June 27, 2019.
• The deadline for submission of claims to ProviderOne for payment will be Monday, June 24, 2019 by 4 p.m.
• The deadline for submission of pharmacy claims to the Point of Sale (POS) for payment will be Sunday June 23, 2019 by 4 p.m.

Provider Payments for the week of June 30, 2019 will be made on Monday, July 8, 2019, including the delivery of Remittance Advices (RAs) and HIPAA 835 remittance files.

Claim submission deadlines will not be changed for the week of June 30, 2019.
• The deadline for submission of claims to ProviderOne for payment will be Monday, July 2, 2019 by 4 p.m.
• The deadline for submission of pharmacy claims to the Point of Sale (POS) for payment will be Sunday July 1, 2019 by 4 p.m.

Date Reported

6/7/2019

ETA

7/8/2019

Provider Impact

All Providers

Workaround

Date Closed

7/8/2019

Discovery Log Number

00317

Discovery Description

The ProviderOne system will be unavailable from 3 p.m. Saturday, June 15 until 9 a.m. Sunday, June 16 (18 hours) due to scheduled maintenance.

Date Reported

6/7/2019

ETA

6/17/2019

Provider Impact

All Providers

Workaround

This outage does not affect the Pharmacy POS Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. The faxes will be processed after the outage is complete.

Date Closed

6/17/2019

Discovery Log Number

00316

Discovery Description

When checking eligiblity in the IVR, Medicare Part D may be played as a benefit when the client does not have Medicare Part D, but rather private insurance pharmacy coverage.

Date Reported

4/22/2019

ETA

6/28/2019

Provider Impact

Phase 1

Workaround

Clients may hear unexpected playback in the IVR leading to confusion. Providers may also hear unexpected benefits from the IVR which erroroneous. Staff may receive complaints from clients or requests to confirm prescription benefits from providers. The only workaround is to check the benefits in another way. This can be done via the client or provider portals, by speaking with an agent, or by checking ProviderOne directly.

Date Closed

6/29/2019

Discovery Log Number

00315

Discovery Description

Routine maintenance scheduled to occur on Friday March 8, 2019 from 6 – 10 p.m. will be extended by 3 hours to execute additional maintenance activities.

As a result, the ProviderOne system will be unavailable beginning Friday March 8, 2019 at 6 p.m. until 1 a.m. Saturday March 9, 2019 (7 hours).

This outage does not affect the Pharmacy POS
Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. The faxes will be processed after the outage is complete.

Date Reported

3/7/2019

ETA

3/9/2019

Provider Impact

All Providers

Workaround

Please report any issues to: mmishelp@hca.wa.gov

Date Closed

3/10/2019

Discovery Log Number

00314

Discovery Description

An issue has been identified with regards to how ProviderOne is calculating a client's age when pricing claims. Claims are denying in error.

Date Reported

1/30/2019

ETA

4/29/2019

Provider Impact

Phase 1

Workaround

It is unknown how widespread the issue is at this time. We are researching currently. No workaround has been established at this time. Claims will be mass adjusted once the system has been corrected.

Date Closed

N/A

Discovery Log Number

00313

Discovery Description

90723 SL claims are denying for Rate Not Found due to an issue with the age range. This rate has now been fixed.

Claims for 90723 SL were denying. They are now paying correctly.

Date Reported

12/21/2018

ETA

1/11/2018

Provider Impact

Phase 1

Workaround

The issue has been fixed. Claims will be mass adjusted.

Date Closed

N/A

Discovery Log Number

00312

Discovery Description

When OHP users have an apostrophe in their OHP user account email address, they are unable to access ProviderOne via OHP because the ProviderOne profiles are unable to be associated to the ProviderOne user account.

Date Reported

12/18/2018

ETA

3/8/2019

Provider Impact

All Providers

Workaround

If the providers organization allows the OHP user account to not have an apostrophe in the email address, the user would get the ProviderOne profile(s) associated to their ProviderOne user account when accessing ProviderOne via OHP.

Date Closed

N/A

Discovery Log Number

00311

Discovery Description

In observance of Thanksgiving, State offices will be closed Thursday, November 22, 2018 and Friday, November 23, 2018. As a result, provider payments for the week of November 19, 2018, will be made on Wednesday, November 21, 2018, including the delivery of Remittance Advices (RAs) and HIPAA 835 remittance files.

Claim submission deadlines have been moved up to ensure that providers are able to receive payment and Remittance Advice documents on November 21, 2018.

The deadline for submission of claims to ProviderOne for payment during the week of Thanksgiving will be Sunday, November 18, 2018 by 4 p.m. because of the holiday.

The deadline for submission of pharmacy claims to the Point of Sale (POS) during the week of Thanksgiving will be Saturday, November 17, 2018 by 6 p.m. because of the holiday.

Date Reported

11/2/2018

ETA

11/26/2018

Provider Impact

All Providers

Workaround

Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

N/A

Discovery Log Number

00310

Discovery Description

A recent update to ProviderOne is causing claims to deny in error for an invalid Place of Service. Issue has been corrected and claims are being identified to be reprocessed currently. This denial will appear on the remittance with Adjustment Reason/Remark code 96/N428.

Date Reported

11/2/2018

ETA

11/9/2018

Provider Impact

Phase 1

Workaround

Provider can either resubmit claim or wait for HCA to reprocess.

Date Closed

N/A

Discovery Log Number

00309

Discovery Description

The ProviderOne system will be unavailable from 6 p.m. Friday, November 9 until 11:59 p.m. Monday, November 12 (78 hours) due to scheduled maintenance.

Date Reported

10/30/2018

ETA

11/13/2018

Provider Impact

All Providers

Workaround

This outage does not affect the Pharmacy POS Pharmacies will still be able to submit claims for processing during this outage. Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

11/13/2018

Discovery Log Number

00308

Discovery Description

Some inpatient claims have denied for ungroupable DRG in error. As a result, affected claims will be mass adjusted as soon as possible. Providers may see denied inpatient claims for missing DRG record.

Date Reported

10/12/2018

ETA

10/26/2018

Provider Impact

Phase 1

Workaround

No workaround possible at this time. Claims will be adjusted and paid as appropriate.

Date Closed

10/27/2018

Discovery Log Number

00307

Discovery Description

Chrome version 69 update removed functions from JavaScript. This update is causing pages to not load and other blank pages within ProviderOne.

Date Reported

9/26/2018

ETA

1/11/2019

Provider Impact

All Providers

Workaround

Stop using Chrome when working within ProviderOne.

Date Closed

10/24/2018

Discovery Log Number

00306

Discovery Description

Several OPPS claims did not go through the EAPG grouper and paid $0.00 in error at either Header or Line level.

Date Reported

7/30/2018

ETA

8/6/2018

Provider Impact

Phase 1

Workaround

No workarounds; a Mass Adjustment has been submitted to reprocess all claims affected. This Mass Adjustment will be completed by the week of 07/30/2018 for payment.

Date Closed

8/7/2018

Discovery Log Number

00305

Discovery Description

The ProviderOne system will be unavailable from 1 a.m. Saturday, July 14 until 10 a.m. Sunday, July 15 (33 hours) due to scheduled maintenance.

Date Reported

7/10/2018

ETA

7/15/2018

Provider Impact

All Providers

Workaround

This outage does not affect the Pharmacy POS Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. The faxes will be processed after the outage is complete.

Date Closed

7/16/2018

Discovery Log Number

00304

Discovery Description

Dental codes D2394, D2161, D2335 are allowed only when done on 4 or more surfaces. Claims are denying when more than 4 surfaces are billed. These codes should be allowed up to 5 surfaces.

Claim lines are denying when more than 4 surfaces are billed.

Date Reported

6/22/2018

ETA

9/21/2018

Provider Impact

Phase 1

Workaround

No workaround, claims will be reprocessed

Date Closed

N/A

Discovery Log Number

00303

Discovery Description

Due to the timing of the State Fiscal Year End, payments to providers for the week of June 25, 2018, will be made on Thursday, June 28, 2018. Remittance Advices (RAs) and HIPAA 835 payment files will also be made available on Thursday, June 28, 2018. Normally payments and remittance advices would be available for providers on Friday, June 29, 2018.

Claim submission deadlines have been moved up to ensure that providers are able to receive payment and Remittance Advice documents on June 28, 2018.

The deadline for submission of claims to ProviderOne in order to receive payment on June 28, 2018 will be 4 p.m. on Monday, June 25, 2018.

The deadline for submission of pharmacy claims to the Point of Sale (POS) in order to receive payment on June 28, 2018 will be 6 p.m. on Sunday, June 24, 2018.

Date Reported

6/19/2018

ETA

6/30/2018

Provider Impact

All Providers

Workaround

Date Closed

6/30/2018

Discovery Log Number

00302

Discovery Description

When creating a new user that has an email address longer than 45 digits the page 'dlgAddNewUser2(Admin) will not accept the additional digits after 45.

Date Reported

6/6/2018

ETA

9/21/2018

Provider Impact

All Providers

Workaround

If a new user is being created and their email address is longer than 45 digits, follow the below: 1. Create the new user account with the normal process except on page 'dlgAddNewUser2(Admin)' enter a dummy/fake email address that is no more than 45 digits- DO NOT APPROVE THE NEW USER ACCOUNT 2. From the Manage Users page (pgUserList(Admin)) click the hyperlink for the new user to access their User Details 3. Roll down to the Communication Detail List 4. Click the hyperlink for the ;Work - Email' and the page 'dlgUpdatecontactDetail(Admin) is displayed 5. Update the email address with the proper email address for the new user 6. You can now approve the new user account and continue the rest of the process for creating the new user account 7. The new user will receive their credentials to the updated email address supplied in step 5

Date Closed

N/A

Discovery Log Number

00301

Discovery Description

The ProviderOne system will be unavailable Saturday, June 9 from 6 a.m. to 6 p.m. due to scheduled maintenance.

This outage does not affect the Pharmacy POS
Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. The faxes will be processed after the outage is complete.

Date Reported

6/4/2018

ETA

6/10/2018

Provider Impact

All Providers

Workaround

Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

N/A

Discovery Log Number

00300

Discovery Description

The same claim is denying for "Claim is an exact duplicate" against itself when the claim is Adjusted. The claim is Adjusted and then it denies on against the Adjusted TCN. This is only happening on procedure codes that are "Once In A Lifetime" procedure codes.

Claims are deny for "Claim is and exact duplicate" that are not a duplicate claim.

Date Reported

4/20/2018

ETA

6/1/2018

Provider Impact

Phase 1

Workaround

Provider can resubmit their claims after 6/1/2018. HCA will identify the claims and adjust the affected claims after 6/1/2018. If unable to wait until the defect is fixed contact HCA regarding claims with this defect.

Date Closed

N/A

Discovery Log: Archived

View all closed Discovery Log items.

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