UHC mental health claims being rejected by payer
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I have submitted multiple claims for UHC clients for mental health and each claim comes back as, “received/acknowledged by payer. Note: This code requires use of entity code.  I have submitted many claims for BCBS with no issues, but UHC continues to not go through. 

 

I am in the state of Missouri. 

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    Gillian

    Hi Aisha, I'd be happy to help with this. The Received status means that the claim has been received by the payer. The "This code requires use of entity code" is an internal status assigned by the insurance payer and does not require any action on your end. You should see these claims update to Accepted, Denied, or Rejected soon as the payer processes the claims. 

    Hi Aisha, I'd be happy to help with this. The Received status means that the claim has been received by the payer. The "This code requires use of entity code" is an internal status assigned by the insurance payer and does not require any action on your end. You should see these claims update to Accepted, Denied, or Rejected soon as the payer processes the claims. 

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    Shayla Hilt

    Hi Gillian. This answer was helpful to me as well.

    Question: I see that my claim says ACCEPTED but there is a notation "Payment Missing" with a triangle and exclamation point on the bottom right. Does this mean that the PAYOR has not yet indicated or entered what the payment amount will be? Or is there something I need to do to address this?

    Thanks, in advance.

     

    Hi Gillian. This answer was helpful to me as well.

    Question: I see that my claim says ACCEPTED but there is a notation "Payment Missing" with a triangle and exclamation point on the bottom right. Does this mean that the PAYOR has not yet indicated or entered what the payment amount will be? Or is there something I need to do to address this?

    Thanks, in advance.

     

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    Gillian

    Hi Shayla, if you find that a claim is Accepted, but you see a Payment Missing message, that means that a payment has not been recorded for that claim. If you're enrolled in Payment Reports with SimplePractice, this will resolve automatically when the Payment Report hits your SimplePractice account. If you're not enrolled in Payment Reports with this payer, or the payer doesn't offer Payment Reports, you'll want to manually enter the insurance payment under Billing > Insurance > Add Payment to reflect that the claim has been paid. 

    Hi Shayla, if you find that a claim is Accepted, but you see a Payment Missing message, that means that a payment has not been recorded for that claim. If you're enrolled in Payment Reports with SimplePractice, this will resolve automatically when the Payment Report hits your SimplePractice account. If you're not enrolled in Payment Reports with this payer, or the payer doesn't offer Payment Reports, you'll want to manually enter the insurance payment under Billing > Insurance > Add Payment to reflect that the claim has been paid. 

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    Valencia Campbell-Chapin

    Hello I'm Valencia and I'm having the same issue with BCBS her in Texas. It was working fine until a week ago. Had a client who switched from UHC to BCBS and now 5 claims have been rejected since the new year started. The code I am getting is A3 DUPLICATE FILE ID CANNOT BE USED TWICE IN 12 MONTHS  (21) I am not sure what to do with this? I am enrolled with ERA and EFT. I am also getting rejections from Cigna stating: Response not possible - error on submitted request data. I also got the same A3 error from Ambetter. How to resolve this issue???? Thanks Valencia

    Hello I'm Valencia and I'm having the same issue with BCBS her in Texas. It was working fine until a week ago. Had a client who switched from UHC to BCBS and now 5 claims have been rejected since the new year started. The code I am getting is A3 DUPLICATE FILE ID CANNOT BE USED TWICE IN 12 MONTHS  (21) I am not sure what to do with this? I am enrolled with ERA and EFT. I am also getting rejections from Cigna stating: Response not possible - error on submitted request data. I also got the same A3 error from Ambetter. How to resolve this issue???? Thanks Valencia

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    Ruth

    Hi Valencia - BCBS (Illinois and Texas specifically) experienced a system error where they reprocessed some claims that had already been accepted. This issue has since been resolved and won't require any additional steps on your part. A similar issue occurred with Cigna, where these rejections were coming from a system-wide issue with the insurance payer. You also don't need to do anything for your Cigna claims to be processed correctly. We are still actively investigating Ambetter claim rejections with the A3 Error Code. 

    Hi Valencia - BCBS (Illinois and Texas specifically) experienced a system error where they reprocessed some claims that had already been accepted. This issue has since been resolved and won't require any additional steps on your part. A similar issue occurred with Cigna, where these rejections were coming from a system-wide issue with the insurance payer. You also don't need to do anything for your Cigna claims to be processed correctly. We are still actively investigating Ambetter claim rejections with the A3 Error Code. 

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    Valencia Campbell-Chapin

    Hi Ruth yes I am still having issues with Ambetter. Cigna, UHC, and BCBS issues have all been resolved. Thanks. Any help you can provide for Ambetter would be helpful.

    Hi Ruth yes I am still having issues with Ambetter. Cigna, UHC, and BCBS issues have all been resolved. Thanks. Any help you can provide for Ambetter would be helpful.

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    Valencia Campbell-Chapin

    Hi Ruth yes I am still having issues with Ambetter. Cigna, UHC, and BCBS issues have all been resolved. Thanks. Any help you can provide for Ambetter would be helpful.

    Hi Ruth yes I am still having issues with Ambetter. Cigna, UHC, and BCBS issues have all been resolved. Thanks. Any help you can provide for Ambetter would be helpful.