ProviderOne Discovery Log

Discovery Log: Open

Prov Log #

00271

Discovery title

Mass adjustment

Description

Some claims submitted with diagnosis code Z940 were denied incorrectly. This mass adjustment is being done to correct the payments.

Subsystem

Claims

Date reported

5/26/2017

ETA

6/30/2017

Workaround

None

Affected providers

Phase 1

Date closed

N/A

Prov Log #

00270

Discovery Title

PDF issues with some browsers

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.

Subsystem

N/A

Date Reported

05/05/2017

ETA

Since this issues is related to Adobe software, we are not responsible for the fix.

Provider Impact

All Adobe users

Workaround

Use Internet Explorer to generate barcode coversheets.

Affected Providers

All providers

Date Closed

N/A

Prov Log #

00268

Discovery Title

Outpatient Therapy Payment

Description

Payments were made from an incorrect fee schedule.

Subsystem

Rates

Date Reported

04/21/2017

ETA

05/31/2017

Provider Impact

Provider

Workaround

None

Affected Providers

Phase 1

Date Closed

N/A

Prov Log #

00264

Discovery Title

National Correct Coding Initiative (NCCI) Changes

Description

A Change Request (CR) was implemented in Release 2 (R2) on 03/11/2017 changing how NCCI is implemented. The system was not enforcing the Claim Category/Methodology properly for Procedure-to-Procedure (PTP) edits. Files were loaded on Reference -> Reference Data Sets -> CCI without regard to claim type. Durable Medical Equipment (DME) edits should only apply to Claim Types P and O (P), Practitioner & Ambulatory Surgical Center Services (PRA) should only apply to Claim Types A, J, L and O (A/J/L) and Outpatient Hospital Services (OPH) should only apply to Claim Types F, M and W (F/M). Also, Medically Unlikely Edits (MUEs) were combined with HCA state policy Max Units on the Procedure code file.

Subsystem

Claims

Date Reported

03/13/2017

ETA

09/30/2017

Provider Impact

Edit 25000 will not longer post on CT A, J, L, P using a blended PTP file. It currently does not post for CT F, M, O, W. Edit 25000 will start posting on CT A, J, L, O (A/J/L) for PTP PRA. Edit 25001 will start posting on CT P, O (P) for PTP DME. Edit 25002 will start posting on CT F, M, W (F/M) for PTP OPH. Edit 03993 will continue to post when HCA or NCCI policy as it does now until NCCI MUE can be removed from Max Units. 03993 currently does not post for CT A, O, F, M, W. Edit 25010 will start posting on CT A, J, L, O (A/J/L) for MUE PRA, Edit 25011 will start posting on CT P, O (P) for MUE DME and Edit 25012 will start posting on CT F, M, W (F/M) for MUE OPH. 03993 will continue to post with 2501% until MUE and HCA policy Max Units can be separated. If both are posted together then consider this an NCCI MUE denial.

Workaround

These edits are federally mandated and will be applied as given to the state. Current NCCI PTP and MUE can be found at https://www.medicaid.gov/medicaid/data-and-systems/ncci/index.html. Providers should be directed here when questioning what the values are. State staff can see what the system is using by navigating to Reference -> Reference Data Sets -> CCI.

Affected Providers

Phase 1

Date Closed

N/A

Prov Log #

00262

Discovery Title

Error message in the ProviderOne application is not understandable when user is performing unlock/reset password function and the user doesn't have an email address on record in their user account

Description

The message received is not understandable (Error: Message undefined) when there is not an email address on record for their user account and they are performing the unlock/reset password functionality.  When the unlock/reset password function is performed, the system emails the reset password to the person but when there is no email address on record, they receive an error message.  On June 30, 2017 there will be an update to the wording of the error message to be more clear/concise.

Subsystem

Security

Date Reported

03/08/2017

ETA

06/30/2017

Provider Impact

All Providers

Workaround

Providers contact your organizations ProviderOne System Administrator to enter appropriate email address to their user account.  After that is completed the user will be able to perform the unlock/reset password function.

Date Closed

N/A

Status

N/A

Prov Log #

00261

Discovery ID

N/A

Discovery Title

E1028 units being cutback when there is PA

Discovery Type

N/A

Description

Units for E1028 are being cutback even though there are units still available in the PA. This occurs when PROC E1028 is Authorized on multiple lines for the same DOS. P1 randomly picks a line that matches and if a line with less units authorized is chosen, the units are cut back.  Since lines are chosen at random, sometimes the claim pays correctly. Authorizations is no longer building PA this way for PROC effective December 2016.   

Severity

N/A

Subsystem

PA/Claims

Date Reported

03/02/2017

ETA

12/31/2017

Provider Impact

Claim pays incorrectly for Proc E1028.

Workaround

Older claims must have the PA corrected to one line. The claim must be voided first (can be by the provider or HCA). Then staff can send an email to Shannon Jackson (Shannon jackson@hca.wa.gov) or Tammy Frahman (Tammy.Frahman@hca.wa.gov) to request that PA for E1028 be corrected so that all units are on one line. Once the PA is updated, the provider or staff can resurrect the claim to pay correctly.  

Affected Providers

Phase 1

Update

N/A

Date Closed

N/A

Status

N/A

Supplement

N/A

Prov Log #

00260

Discovery ID

N/A

Discovery Title

Locked ProviderOne OHP user account error message Close button non-functional when using Chrome browser

Discovery Type

N/A

Description

When using the Chrome browser to access ProviderOne via OneHealthPort (OHP) and the ProviderOne OHP user account is ‘locked’ for that domain on page ‘pgUserGeneral’; the ‘Close’ button is non-functional for the message displayed. 

Severity

N/A

Subsystem

Security

Date Reported

02/24/2017

ETA

07/01/2017

Provider Impact

Phase 1

Workaround

Close out of the tab/window the message is displayed on, contact your organizations ProviderOne System Administrator and notify them your ProviderOne OHP user account is locked. 

Affected Providers

N/A

Update

N/A

Date Closed

N/A

Status

N/A

Supplement

N/A

Discovery Log: Closed

View all closed Discovery Log items.