ProviderOne Discovery Log

Discovery Log: Open

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 Number

00297

Discovery Description

Dental Anesthesia Denying in Error

Date Reported

3/5/2018

ETA

12/31/2999

Provider Impact

Phase 1

Workaround

None. Claims will be reprocessed when issue is resolved.

Date Closed

N/A

Discovery Log Number

00295

Discovery Description

Currently if a claim is billed for a newborn using the mom's Client ID, Special Claim Indicator "B" should be used. This is done using the claim note of "SCI=B". If the infant is a twin or triplet, a claim comment is used to indicate which baby the current claim is for. For example, "Twin B" or "Triplet C". ProviderOne has been updated with new Special Claim Indicators.

Date Reported

2/8/2018

ETA

9/30/2018

Provider Impact

All Providers

Workaround

Providers should now bill with the new Special Claim Indicators instead of claim comments. Use the following new values as appropriate: "SCI=BA" for Baby A, "SCI=BB" for Baby B and "SCI=BC" for Baby C. It is not necessary to indicate the type of multiple birth, only to differentiate the newborns. For single births, continue to use the "SCI=B" note. It is always encouraged to get newborns their own Client IDs immediately to prevent possible claim denials or improper payments.

Date Closed

N/A

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

00299

Discovery Description

Due to dependencies with State Fiscal Agencies, provider payments for the week of March 26, 2018 will be made on Thursday, March 29, 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 RA documents on Thursday, March 29, 2018. The deadline for submission of claims to ProviderOne for payment will be moved up to 4 p.m. Monday, March 26, 2018. The deadline for submission of pharmacy claims to the Point of Sale (POS) will be moved up to 4 p.m. Sunday, March 25, 2018.

Date Reported

3/16/2018

ETA

3/30/2018

Provider Impact

All Providers

Workaround

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

Date Closed

N/A

Discovery Log Number

00298

Discovery Description

The ProviderOne system will be unavailable Saturday, March 10 from 4:30 a.m. to 4:30 p.m. due to scheduled maintenance.

Date Reported

3/5/2018

ETA

3/11/2018

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

Date Closed

N/A

Discovery Log Number

00296

Discovery Description

The ProviderOne system will be unavailable from 2 a.m. Saturday, February 17 until 6 p.m. Monday, February 19 (64 hours) due to scheduled maintenance.

Date Reported

2/12/2018

ETA

2/20/2018

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

Date Closed

N/A

Discovery Log Number

00294

Discovery Description

The ProviderOne system will be unavailable from 1 a.m. Saturday, January 13 until 10 a.m. Sunday, January 14 (33 hours) due to scheduled maintenance.

Date Reported

1/8/2018

ETA

1/14/2018

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

Date Closed

N/A

Discovery Log Number

00293

Discovery Description

Currently in "BackupDocumentation" page is preventing providers from attaching .docx files through ProviderOne. This is because before 2007 Microsoft word save format is .doc, but starting 2007 this has been updated to .docx.

Date Reported

1/8/2018

ETA

4/6/2018

Provider Impact

All Providers

Workaround

.docx files will need to be converted to a different file type or backup will need to be submitted using a documentation coversheet.

Date Closed

N/A

Discovery Log Number

00292

Discovery Description

If a provider has unsubscribed to the alert 'Provider Modification Review is Completed' and submits a modification to their provider file, Provider Enrollment staff are unable to approve the modification.

Date Reported

12/22/2017

ETA

4/6/2018

Provider Impact

All Providers

Workaround

If provider has unsubscribed to the alert 'Provider Modification Review is Completed' and is going to submit a modification to their provider file, subscribe back to that alert (on page 'pgProviderPortal(Provider)' click the 'ManageAlerts' button > move the alert 'Provider Modification Review is Completed' from 'Unsubscribed Alerts' to 'Available Alerts' and click 'OK' button).

Date Closed

N/A

Discovery Log Number

00291

Discovery Description

Social Service Providers are receiving a message undefined upon clicking save after editing SS claim Templates.

Date Reported

12/20/2017

ETA

1/8/2018

Provider Impact

Phase 2

Workaround

Submit Social Service Claims using the Social Service Billing Screens

Date Closed

1/8/2018

Discovery Log Number

00290

Discovery Description

The ProviderOne system will be unavailable from 6 a.m. Saturday, December 16 until 9 a.m. Sunday, December 17 (27 hours) due to scheduled maintenance.

Date Reported

12/11/2017

ETA

12/17/2017

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

00289

Discovery Description

Resurrecting claims that were denied in error. The HCPCS x NDC Combination was valid, but claims denied in error because the association was not properly loaded into ProviderOne. Claims that were previously denied in error will be reprocessed for payment.

Date Reported

12/6/2017

ETA

3/31/2018

Provider Impact

Phase 1

Workaround

None

Date Closed

N/A

Discovery Log Number

00288

Discovery Description

On page 'pgUserGeneral(Admin)' when maintaining user accounts, fields that are required don't have an asterisk on the screen noting that they are required; the fields are First Name, Last Name, User Type, User Name, EID, Date of Birth, Start Date and Expiration Date. If a required field has the data cleared in a user account, the error message is not descriptive or no error message is displayed when saving an update; the fields are First Name, Last Name, User Name, EID, and Date of Birth

Date Reported

11/29/2017

ETA

4/6/2018

Provider Impact

All Providers

Workaround

When maintaining user accounts and performing updates, verify the First Name, Last Name, User Name, EID and Date of Birth have not been removed before clicking Save button.

Date Closed

N/A

Discovery Log Number

00287

Discovery Description

In observance of Thanksgiving, State offices will be closed Thursday, November 23, 2017 and Friday, November 24, 2017. As a result, provider payments for the week of November 20, 2017, will be made on Wednesday, November 22, 2017, 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 22, 2017.

Date Reported

11/8/2017

ETA

11/27/2017

Provider Impact

All Providers

Workaround

The deadline for submission of claims to ProviderOne for payment during the week of Thanksgiving will be Sunday, November 19, 2017 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 18, 2017 by 6 p.m. because of the holiday.

Date Closed

N/A

Discovery Log Number

00286

Discovery Description

The ProviderOne system will be unavailable from 3 a.m. until 7:30 p.m. Saturday, October 28 (16.5 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. The faxes will be processed after the outage is complete.

Date Reported

10/23/2017

ETA

10/30/2017

Provider Impact

All Providers

Workaround

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

Date Closed

N/A

Discovery Log Number

00285

Discovery Description

System issue was allowing duplicate dental claims to pay incorrectly. System has now been fixed. All affected claims have been identified and are being reprocessed.

Date Reported

10/17/2017

ETA

10/27/2017

Provider Impact

Phase 1

Workaround

Date Closed

N/A

Discovery Log Number

00284

Discovery Description

Inpatient claims were not Grouping to a DRG which was causing claims to deny as being Un-Groupable. All effected claims have been identified and have already been reprocessed.

Date Reported

10/16/2017

ETA

10/27/2017

Provider Impact

Phase 1

Workaround

Date Closed

N/A

Discovery Log Number

00283

Discovery Description

The ProviderOne system will be unavailable from 4:30 a.m. until 5 p.m. Saturday, September 30, (12.5 hours) due to scheduled maintenance.

Date Reported

9/25/2017

ETA

10/1/2017

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

00282

Discovery Description

The Pharmacy POS system will be unavailable from 10 p.m. Friday, September 22 to 4 a.m. Saturday, September 23 (6 hours) due to scheduled maintenance. During this outage you will not be able to submit pharmacy claims for processing.

Date Reported

9/18/2017

ETA

9/23/2017

Provider Impact

All Providers

Workaround

This outage does not affect the ProviderOne System/Portals This outage only impacts the Pharmacy POS system, all other ProviderOne functionality will remain fully operational during this period.

Date Closed

N/A

Discovery Log Number

00281

Discovery Description

The Pharmacy POS system will be unavailable from 10 p.m. Friday, September 8 to 4 a.m. Saturday, September 9 (6 hours) due to scheduled maintenance. During this outage you will not be able to submit pharmacy claims for processing.

Date Reported

8/30/2017

ETA

9/8/2017

Provider Impact

All Providers

Workaround

This outage does not affect the ProviderOne System/Portals This outage only impacts the Pharmacy POS system, all other ProviderOne functionality will remain fully operational during this period. Please report any issues to: mmishelp@hca.wa.gov.

Date Closed

N/A

Discovery Log Number

00280

Discovery Description

Providers have submitted several tickets because their fresh claims are denying with error 00265 (original TCN not on file). They are submitting claims from templates after adjusting/voiding a claim. Issue happens when provider user navigates to adjust/void claim and submits the adjustment or void then navigates to create claim from claim template and submits. The page names change from submit to adjust or void and fields for original TCN appear on the pages. Providers who adjust/void claims and submit claims from templates

Date Reported

8/18/2017

ETA

10/20/2017

Provider Impact

All Providers

Workaround

Please do not create/submit claims from templates after you adjust/void a claim.

Date Closed

N/A

Discovery Log Number

00279

Discovery Description

The ProviderOne system will be unavailable from 1 a.m. Saturday, August 19 to 10 a.m. Sunday, August 20 (33 hours) due to scheduled maintenance.

Date Reported

N/A

ETA

8/19/2017

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

N/A

Discovery Log Number

00278

Discovery Description

The ProviderOne system will be unavailable from 6 a.m. Saturday, August 12 to 6 a.m. Sunday, August 13 (24 hours) due to scheduled maintenance.

Date Reported

8/8/2017

ETA

8/13/2017

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

8/14/2017

Discovery Log Number

00277

Discovery Description

The ProviderOne system will be unavailable from 4 a.m. Saturday, July 29 to 1 a.m. Sunday, July 30 (21 hours) due to scheduled maintenance. This outage does not affect the Pharmacy POS

Date Reported

7/24/2017

ETA

7/31/2017

Provider Impact

All Providers

Workaround

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

7/31/2017

Discovery Log Number

00276

Discovery Description

An issue with the Grouper Version for OPPS and Outpatient Medicare Crossover Claims has been identified with claims submission on/after 04/21/2017 with some EAPG's being incorrectly assigned at time of payment. The issue is currently being fixed/tested and will go into the ProviderOne Production environment on 07/31/2017. HCA will complete Mass Adjustments which will be begin on 07/31/2017 with the last batch to be completed by 08/21/2017. Provider - Payments may be incorrect and claims may be adjusted when adjustment may not be necessary and then repaid the same amount.

Date Reported

7/21/2017

ETA

8/28/2017

Provider Impact

Phase 1

Workaround

N/A

Date Closed

N/A

Discovery Log Number

00275

Discovery Description

The ProviderOne system will be unavailable Saturday, July 15 from 4:30 a.m. to 7:30 p.m. due to scheduled maintenance.

Date Reported

7/10/2017

ETA

7/15/2017

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

N/A

Discovery Log Number

00274

Discovery Description

Some providers are receiving paper RA’s which include adjustment “OFIN Invoice” lines related to a different provider.

Date Reported

7/10/2017

ETA

10/20/2017

Provider Impact

All Providers

Workaround

The dollar amounts paid are correct. The unrelated adjustments should be ignored. No client or TCN specific information is included on the incorrect RA’s. Staff may receiving calls/tickets from confused providers. Providers may be confused by the number of pages in their PDF RA’s.

Date Closed

N/A

Discovery Log Number

00258

Discovery Description

A system error was made in regards to codes D4341/D4342 causing claims to deny in error. This error has been fixed and claims are being mass adjusted.

Date Reported

2/10/2017

ETA

2/17/2017

Provider Impact

Phase 1

Workaround

The system has now been corrected and claims will no longer deny in error. Mass adjustment should be completed by 02/17/2017

Date Closed

2/21/2017

Discovery Log Number

00259

Discovery Description

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

Date Reported

2/21/2017

ETA

3/10/2017

Provider Impact

All Providers

Workaround

N/A

Date Closed

4/3/2017

Discovery Log Number

00263

Discovery Description

In order to support additional required maintenance activities, the Routine Maintenance previously scheduled for Friday, March 10, 2017 has been moved to Saturday, March 11, 2017. ProviderOne will be unavailable during this updated scheduled maintenance period.

Date Reported

3/9/2017

ETA

3/12/2017

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

3/13/2017

Discovery Log Number

00264

Discovery Description

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

Date Reported

3/15/2017

ETA

6/30/2017

Provider Impact

All Providers

Workaround

N/A

Date Closed

4/4/2017

Discovery Log Number

00266

Discovery Description

ProviderOne outage planned for Saturday April 1, 2017

Date Reported

3/27/2017

ETA

4/3/2017

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

4/3/2017

Discovery Log Number

00267

Discovery Description

The ProviderOne system will be unavailable Saturday, April 22 from 6 a.m. to 7 p.m. due to scheduled maintenance.

Date Reported

4/18/2017

ETA

4/22/2017

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

4/25/2017

Discovery Log Number

00269

Discovery Description

In order to support additional required maintenance activities, the routine maintenance previously scheduled for Friday, May 5, 2017 has been moved to Saturday, May 6, 2017 from 6 a.m. through Sunday, May 7, 2017 3 p.m. ProviderOne will be unavailable during this updated scheduled maintenance period.

Date Reported

5/1/2017

ETA

5/7/2017

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

5/8/2017

Discovery Log Number

00271

Discovery Description

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

Date Reported

5/26/2017

ETA

6/30/2017

Provider Impact

Phase 1

Workaround

N/A

Date Closed

6/7/2017

Discovery Log Number

00260

Discovery 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.

Date Reported

2/24/2017

ETA

7/1/2017

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.

Date Closed

N/A

Discovery Log Number

00261

Discovery 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.

Date Reported

3/2/2017

ETA

12/31/2017

Provider Impact

Phase 1

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.

Date Closed

N/A

Discovery Log Number

00262

Discovery 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.

Date Reported

3/8/2017

ETA

6/30/2017

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

Discovery Log Number

00264

Discovery Description

A change was implemented in ProviderOne 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. Durable Medical Equipment (DME) edits should only apply to Med Vendor and Part B XO Claim Types. Practitioner & 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. 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.

Date Reported

3/13/2017

ETA

9/30/2017

Provider Impact

Phase 1

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 if you have any questions.

Date Closed

N/A

Discovery Log Number

00268

Discovery Description

Payments were made from an incorrect fee schedule.

Date Reported

4/21/2017

ETA

5/31/2017

Provider Impact

Phase 1

Workaround

None

Date Closed

N/A

Discovery Log Number

00272

Discovery Description

Backup ventilator rentals (ventilator procedures billed with both RR and U2 modifiers) are paying incorrectly at full rental rate. This is for claims paid by the system after 11/18/2016 and will be fixed for R4 (6/30/2017). A mass adjustment will be done on these claims in early July 2017.

Date Reported

6/29/2017

ETA

7/1/2017

Provider Impact

Phase 1

Workaround

N/A

Date Closed

N/A

Discovery Log Number

00273

Discovery Description

When using Internet Explorer (IE) to access ProviderOne and using the Printer icon in ProviderOne to get a screen shot, the printout received is not of the screen requested but prints a line with Error 404: A recent Microsoft security update for IE has this printing issue noted as known and Microsoft is researching the problem.

Date Reported

6/21/2017

ETA

9/25/2017

Provider Impact

All Providers

Workaround

There are two ways to get the print from IE: 1. From the ProviderOne screen wanting the screen shot - On the IE menu bar > click File > click Print > verify the Printer is the printer you want to print to > click Print 2. From the ProviderOne screen wanting the screen shot - press/hold Ctrl key > press P > verify the Printer is the printer you want to print to > click Print 1.Note: browsers Google Chrome, Firefox and Safari do not experience this issue

Date Closed

9/25/2017

Discovery Log: Archived

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