ProviderOne Discovery Log

Discovery Log: Open

Prov Log #

00266

Discovery ID

N/A

Discovery Title

ProviderOne outage planned for Saturday April 1, 2017

Discovery Type

N/A

Description

The ProviderOne system will be unavailable Saturday, April 1 from6:00 a.m. to 6:00 p.m. due to scheduled maintenance.

Severity

N/A

Subsystem

N/A

Date Reported

03/27/2017

ETA

04/02/2017

Provider Impact

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.

Workaround

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

Affected Providers

All Providers

Update

N/A

Date Closed

N/A

Status

N/A

Supplement

N/A

Prov Log #

00265

Discovery ID

N/A

Discovery Title

N/A

Discovery Type

N/A

Description

Providers are receiving a Message undefined when they try to Adjust/Resubmit claims from the provider portal

Severity

N/A

Subsystem

Provider portal claim adjustment/resubmission

Date Reported

03/15/2017

ETA

06/30/2017

Provider Impact

All

Workaround

N/A

Affected Providers

All

Update

N/A

Date Closed

N/A

Status

N/A

Supplement

N/A

Prov Log #

00264

Discovery ID

N/A

Discovery Title

N/A

Discovery Type

N/A

Description

A change was implemented in ProviderOne on March 11, 2017 changing how NCCI is implemented. The system was not enforcing the Claim Category/Methodology properly for Procedure-to-Procedure (PTP) edits. Durable Medical Equipment (DME) edits should only apply to Med Vendor and Part B XO Claim Types. Practitioner and Ambulatory Surgical Center Services (PRA) should only apply to Professional, ASC, EPSDT and Part B XO Claim Types. Outpatient Hospital Services (OPH) should only apply to Claim Types OPPS, Outpatient and Part A XO Outpatient Claim Types. Also, Medically Unlikely Edits (MUEs) unit edits were combined with HCA state policy unit edits.

Severity

N/A

Subsystem

Claims

Date Reported

03/13/2017

ETA

09/30/2017

Provider Impact

Currently NCCI PTP denials are giving CARC denial reason 236 for ASC, Professional, EPSDT and Med Vendor Claim Types. After this change NCCI PTP denials will have same denial reason and will post on the previous Claim Types, but now will also post on Part B XO, OPPS, Outpatient and Part A XO Outpatient Claim Types. Currently NCCI MUE and HCA state policy unit denials are giving CARC/RARC denial reason A1/N362. After this change HCA state policy unit denials will have the same denial reason for the same claim types. However, NCCI MUE denials will use reason combination 273/N362 which is unique to all their ProviderOne edits. NCCI MUE unit edit and HCA state policy unit edit may post together when the reason is NCCI MUE only, until they can be separated. If both denials are present then consider this only 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 on the Medicaid website if you have any questions.  

Affected Providers

Phase 1

Update

N/A

Date Closed

N/A

Status

N/A

Supplement

N/A

Prov Log #

00262

Discovery ID

N/A

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

Discovery Type

N/A

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.

Severity

N/A

Subsystem

Security

Date Reported

N/A

ETA

N/A

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.

Affected Providers

N/A

Update

N/A

Date Closed

N/A

Status

N/A

Supplement

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

Prov Log #

00259

Discovery ID

N/A

Discovery Title

N/A

Discovery Type

N/A

Description

Within DDE entering a claim note with special characters the system will pop up and error message if an inappropriate character is used.

Severity

N/A

Subsystem

Provider Portal/Claims DDE

Date Reported

02/21/2017

ETA

03/10/2017

Provider Impact

Phase 1 and 2

Workaround

N/A

Affected Providers

Phase 1 and 2

Update

N/A

Date Closed

N/A

Status

N/A

Supplement

N/A

Discovery Log: Closed

View all closed Discovery Log items.