Author Archives: Joe Dainwood

This Thursday evening, February 4, we will be changing the verbiage for NEBO0145* to better represent what it is alerting on. Current: Eligibility limited to {1}. Ensure benefits match service. Future: Response has IL Medicaid Companion Guide message. Coverage may be … Continue reading →

As part of our 1st of the month processing schedule on Monday, February 1, our Batch File Processing and Coverage Discovery services will be unavailable until after 2:00p.m. CT.  This is being done to insure that real-time requests receive processing priority. … Continue reading →

REMINDER – Medicare Usage – New Rules of Behavior – IMPORTANT Medicare continues to monitor eligibility transaction volumes on the 1st and 1st Monday of each month. The purpose of this monitoring is to maintain the performance of their eligibility system, … Continue reading →

Release Date: Thursday, January 28, 2016 at 10:00p.m. CT Change Overview: Experian Health  –  Processing Reminder for February 1, 2016 The Experian Health Systems Team remains committed and focused on delivering the highest level of availability for all products. We continue to … Continue reading →

Click below to see the latest available payer updates. Update – New Real-Time Payers, HIX, Claims and Remits (01.28.2016)

[4:00p.m CT]  The issue causing alerts to process more slowly than normal has been resolved.  We did not send a notification during this issue because we had not been able to assess the impact before it was resolved.  We apologize … Continue reading →

Experian Health – Processing Reminder for February 1, 2016 The Experian Health Systems Team remains committed and focused on delivering the highest level of availability for all products. We continue to make technology, people, and process changes to improve our service. … Continue reading →

This Thursday evening,  January 28, 2016, the following Epic NEBO alerts will be retired: NEBO0519: Payer Unable to Respond at current Time This alert has outdated logic and is currently never firing. If a payer is unable to respond to … Continue reading →

Click below to see the latest available payer lists (01.15.2016) Real-Time Payers – 01152015 Claims and Remits Payers – 01152016 Claims and Remits Payers – 01152016 – Updates Click below to see the latest available payer lists (01.11.2016) New Payers, Real-Time, HIX, … Continue reading →

Update Post – 01.15.2015 RQA Configuration File Upload Activations Effective 01.06.2016, RQA Configuration Files/Alerts will be available within 15 minutes of activation. Alerts will be available to begin firing on the quarter hour after they have been activated. Please contact Customer … Continue reading →

Release Date: Thursday, January 14, 2016 at 10:00p.m. CT Change Overview: Tonight – Expected Product Downtime During Maintenance Window As part of our regularly scheduled deployment and maintenance, (between 10:00p.m. to 12:00a.m. CT.) we expect a brief 45-minute outage to begin at … Continue reading →

Click below to see the latest available payer lists (01.11.2016) Payer List Alphabetical, Real-Time 20160111

Release Date: Thursday, January 7, 2016 at 10:00p.m. CT Change Overview: Tonight – Patient Estimates and Registration QA (PPE/RQA) This evening, we are performing product system and infrastructure maintenance during our regularly scheduled deployment which may disrupt normal PPE/RQA processing from 10:00p.m. … Continue reading →

Blue Cross and Blue Shield of Illinois (BCBSIL), Blue Cross and Blue Shield of Montana (BCBSMT), Blue Cross and Blue Shield of New Mexico (BCBSNM), Blue Cross and Blue Shield of Oklahoma (BCBSOK), and Blue Cross and Blue Shield of … Continue reading →

Update – 01.06.2016 Update to EDI Claim Edits Effective December 30, 2015 Changes were made to some of the edits released into production last week, as previously communicated.  Please make system updates as provided in the following. UHC_EDI_Claim_Edits_20160106 Previous: Effective Dec. … Continue reading →

Click below to see the latest available payer lists (01.04.2016) Payer List Alphabetical, Real-Time 20160104

1. Issue: UnitedHealthcare is experiencing a production problem with their remit generation platform.  This is a GLOBAL issue affecting delivery of remits to all trading partners and affects all remits associated with UHC and its affiliate payers. Status:  RESOLVED RE-OPENED … Continue reading →

Release Date: Thursday, December 17, 2015 at 10:00p.m. CT Reminder – Holiday Deployment Schedule: Over the next two weeks, we will not have weekly deployments on Thursday, December 24, 2015 (Christmas Eve) and Thursday, December 31, 2015 (New Year’s Eve). Our … Continue reading →

As of 10:26a.m. CT, this issue has been resolve.  Again we apologize for any inconvenience. _____________________ Currently when accessing the Collections Chevron from within ECN an error displays “Page cannot be displayed”. We have Development and Production control teams actively researching … Continue reading →

Click below to see the latest available payer lists (12.17.2015) Real-Time Payers Claims & Remits Payer 83x_Payer List Updates WorkComp Payer List WorkComp Payer List Updates  

Until further notice, Bravo Health is currently unavailable.  There is no ETA at this time.  We apologize for any inconvenience.

Click below to see the latest available payer lists (12.14.2015) Payer List Alphabetical, Real-Time  20151214

12.16.2015 1. Issue:  UnitedHealthcare is experiencing a production problem with their remit generation platform.  This is a GLOBAL issue affecting delivery of remits to all trading partners and affects all remits associated with UHC and its affiliate payers. Status:  RESOLVED … Continue reading →

As of 12.15.2015, Fresenius Medical Care and World Insurance is not offering real-time Eligibility and Claim Status processing.  We apologize for any inconvenience.    

Release Date: Thursday, December 10, 2015 at 10:00p.m. CT Change Overview: eCareNEXT Bar Update Users will be prompted to download a new version of the NEXT Bar beginning on Friday, December 11, 2015.   The new version does not change the functionality … Continue reading →

Valued Experian Health Customer, In our ongoing effort to improve the customer experience for all Experian Health customers, Experian Health is excited to announce that we will be moving to a unified set of Support Case Priorities for all of … Continue reading →

Click below to see the latest available payer lists (12.08.2015) Alphabetical Payer List, Real-Time 20151207

Users will be prompted to download a new version of the NEXT Bar beginning on Friday, December 11th.   The new version does not change the functionality or appearance of the NEXT bar.  The only noticeable change is to popup a warning message … Continue reading →

Earlier this week we posted about changes coming this Thursday evening, December 10th for NEBO0005: “Patient Birth Date Does Not Match That for the Patient on the Database” and NEBO0512: “DOB in REG does not match DOB in ELIG”. These … Continue reading →

A list of scheduled payer downtimes is available below. Payer Downtime December 2015

Release Date: Thursday, December 03, 2015 at 10:00p.m. CT Change Overview: Urgent Maintenance – Expected Product Downtime, Tonight, 10:00p.m. CT Tonight (12.03.2015) we will be performing an urgent maintenance change during our regularly scheduled deployment that may disrupt normal processing from … Continue reading →

Click below to see the latest available payer lists (12.02.2015) Real-Time Payers Claims & Remits Payers 83X Payers Updates

Tomorrow evening (12.03.2015) we will be performing an urgent maintenance change during our regularly scheduled deployment that may disrupt normal processing from 10:00p.m. to 12:00a.m. CT.  If these changes are completed prior to 12:00a.m. or if delayed, an update will … Continue reading →

As part of our 1st of the month processing schedule, Batch File Processing and Coverage Discovery are now online and processing normally.

11/30/2015 1:40pm – Although real-time processing has been processing normally since 11:15am CT, we are still processing queued transactions that were submitted from approximately 10am to 11:15am.  We should complete the backlog of request by 3pm.  Thanks for your patience. 11/30/2015 … Continue reading →

We want remind you of the new Medicare rules related to eligibility transaction volume for December 1st and December 7th. Please read the below. Medicare continues to monitor eligibility transaction volumes on the 1st and 1st Monday of each month. … Continue reading →

11.24.2015 – As of 1:30p.m. CT This issue has now been resolved.  Again, we are sorry for the inconvenience. 11.23.2015 – As of 1:45p.m. CT UHC is currently returning inaccurate out of pocket amounts. We are working with the payer … Continue reading →

Release Date: Thursday, November 19, 2015 at 10:00p.m. CT Change Overview: Tonight – eCareNEXT Bar Update Users will be prompted to download a new version of the eCareNEXT Bar beginning on Friday November 20th.  The new version does not change … Continue reading →

Click below to see the latest available payer lists (11.18.2015) Real-Time Payers Claims & Remits Payers  

In an effort to streamline our payer connections, we will be consolidating Sierra Health Plan with Health Plan of Nevada effective November 30, 2015.  All transactions for Sierra Health Plan should be directed to Health Plan of Nevada before this date. … Continue reading →

This Thursday evening, November 19, we will be deactivating the Epic embedded alert NEBO0038 and adjusting the verbiage of NEBO0019 to reflect the fact that Medicaid Replacement and Managed Care Coordinator are indeed the same. This is an effort to reduce … Continue reading →

Release Date: Thursday, November 12, 2015 at 10:00p.m. CT Change Overview: Reminder – RQA/PPE Processing, Tonight Tonight, during our regularly scheduled maintenance window, RQA/PPE clients may experience intermittent service disruptions between 10-11p.m. CT. Reminder – FTPS (FTP over SSL) Upgrade, … Continue reading →

Medicare continues to monitor eligibility transaction volumes on the 1st and 1st Monday of each month. The purpose of this monitoring is to maintain the performance of their eligibility system, as they continue to see higher than normal transaction volumes … Continue reading →

Effective for services rendered on and after December 1, 2015 – BCBSTX Medicaid (STAR & CHIP) are changing Third Party Administrators (TPAs) to our BCBSTX subsidiary – TMG. BCBSTX Medicaid is transitioning all its administrative functions to TMG – Customer … Continue reading →

Release Date: Thursday, November 5, 2015 at 10:00p.m. CT Change Overview: Reminder – Disaster Recovery Testing, Rescheduled to Nov. 12, 2015 Disaster Recovery Testing is scheduled for Nov. 12, 2015 between 10:00p.m. and 12:00a.m.  During this time, clients may experience intermittent service disruptions … Continue reading →

Click below to see the latest available 83X payer lists (11.05.2015) 83X_Payers_Updates_20151105 Click below to see the latest available payer lists (11.05.2015) Real-Time Payers Claims & Remits Payers WorkComp_Payer List

There is a known issue with UHC NOA responses – some requests are returning a response of “No HTML Response Found”. We have identified the fix for this and expect it to move during our build on Thursday night. Please … Continue reading →

[11 03 2015 @ 7:30 a.m. CT] Batch file processing and Coverage Discovery are now online and processing normally.   We apologize for any inconvenience. [11 02 2015 @ 12:30p.m. CT]  Batch file processing will be delayed on 11.02.2015 until further notice. Additionally, … Continue reading →

[11 02 2015 @12:03pm CT] Medicare is back online, however, processing may remain slow as the payer processes the backlog of transactions. [11.02.2015 @ 10:10 am CST]  Currently, Medicare is not responding and/or timing out.   We are working with the payer … Continue reading →

[11 02 2015 @ 1:40pm CT] Real-time transactions are processing normally.  We continue to monitor the system as we process the backlog of transactions.  Thanks for your patience! [11 02 2015 @ 12:45pm CT] Transactions are processing slow for Eligibility, Address … Continue reading →

Epic NEBO Alerts Deployment 10/30/2015 Alert Action Notes 0057 – Alternate payer(s) found. Contact for benefits: {0}{1} New This alert notifies end users of alternate payers. These payers are administrated by the original payer queried but do not house the … Continue reading →

Release Date: Thursday, October 29, 2015 at 10:00p.m. CT Change Overview: Reminder – Disaster Recovery Testing, Rescheduled to Nov. 12, 2015 The Disaster Recovery Testing that was scheduled for October 22nd has been postponed until Nov. 12, 2015 between 10:00p.m. and 12:00a.m.  … Continue reading →

Epic NEBO Alerts Deployment 10.27.2015 Alert Action Notes 0056 – Eligibility Response indicates SLMB New The response indicates the patient is part of the Service Limited Medicare Beneficiary Program.. 6401 – Kentucky Medicaid Exclusion: {1} New Lists out any KY … Continue reading →

10.26.2015 – Once again we want to remind our provider community of the concerns that CMS continues to have related to the volume of eligibility transactions being processed through the Medicare System( HETS) on the 1st of the month.  There are … Continue reading →

Release Date: Thursday, October 22, 2015 at 10:00p.m. CT Change Overview: Reminder – Disaster Recovery Testing, Rescheduled to Nov. 12, 2015 The Disaster Recovery Testing that was scheduled for October 22nd has been postponed until Nov. 12, 2015 between 10:00p.m. … Continue reading →

Click below to see the latest available 83X payer lists (10.26.2015) 83X_Payers_Updates_20151020 Click below to see the latest available payer lists (10.21.2015) Real-Time Payer List Claims & Remits Payer List  

The previously reported NOA issue has been resolved. UHC NOA processing is back to normal.

Reminder – Disaster Recovery Testing Next Thursday on October 22, 2015 between 10:00p.m. and 12:00a.m., we will be conducting disaster recovery testing.  Clients may experience intermittent service disruptions for the entire two hours as we test and deploy changes.

Release Date: Thursday, October 15, 2015 at 10:00p.m. CT Change Overview: Reminder – eCareNext – Nextbar Tonight, a new version of the Click Once Nextbar will be included in our weekly deployment. This new version provides for an improved method of In-Process … Continue reading →

Payer Updates: September 22 – October 5, 2015, Experian’s Payer Team has added the following new payers and made improvements to existing payers. New Payers-RT_HIX_Claims_Remits_10092015      

Release Date: Thursday, October 8, 2015 at 10:00p.m. CT Change Overview: Maintenance Reminder – Tonight Tonight during our regularly scheduled maintenance window, we anticipate product downtime to be 30-60 minutes which will begin shortly after 10:00p.m. CT.  All products will be … Continue reading →

Maintenance Reminder – Thursday, October 8, 2015 This week, during our regularly scheduled maintenance window, we anticipate product downtime to be 30-60 minutes which will begin shortly after 10:00p.m. CT.  All products will be impacted during this time. CMS Claims … Continue reading →

October 6, 2015 Medicare/CMS Eligibility Scheduled Downtime October 9-11, 2015 We received the following downtime schedule from CMS for Medicare A&B eligibility. Friday, October 9, 2015 from 8:30 PM ET to 3:00 PM ET on Sunday, October 11, 2015.

09.25.2015 – This evening, Experian Health will be performing emergency maintenance on some redundant equipment starting at 10:00p.m. CT.  We do not anticipate any slowness or downtime during this maintenance, but we feel that it is necessary to keep you … Continue reading →

Release Date: Thursday, September 24, 2015 at 10:00p.m. CT (Update, 4:50p.m. CT – Disaster Recovery Testing, as previously communicated below has been posponed for this evening.) Reminder – Regularly Scheduled Disaster Recovery Testing – Tonight, Sept. 24, customers may experience … Continue reading →

Epic NEBO Alerts Deployment 9/17/2015 Alert Action Notes 0008 – Patient has Medicare A Modified Logic added to recognize replacements and not fire alert.  0009 – Patient has Medicare B Modified Logic added to recognize replacements and not fire alert. … Continue reading →

Release Date: Thursday, September 17, 2015 at 10:00p.m. CT Change Overview: Preauthorization Knowledge Base Improves Authorization Response printing to include bold font on the results line. OrderChecker – Legacy Corrects an issue with ICD-9 listings not showing for non-specific ICD-9 codes. … Continue reading →

Release Date: Thursday, September 10, 2015 at 10:00p.m. CT Change Overview: Reminder – eCareNext: Tonight, during the regularly scheduled maintenance window, eCareNEXT will be offline from approximately 10:00p.m. CT to 10:45p.m. CT for a system upgrade. Reminder – eCareNext, Patient … Continue reading →

Release Date: Thursday, September 3, 2015 at 10:00p.m. CT Update – RQA Fixed an AlertBuilder tool issue where the Copy Alert would crash when using IE9. Accepting GE alerts and adding a process to release the Postback when needed. Any … Continue reading →

Release Date: Thursday, August 27, 2015 at 10:00p.m. CT Change Overview: Reminder – Friday, August 28 PPE, RQA, PayNav, ERA, and eCareOnline – Scheduled Downtime We are performing a hardware upgrade this Friday, August 28, from 8:00p.m. CT until Saturday, August … Continue reading →

08.24.2015 – Rocky Mountain Health Plan is currently not accepting any new enrollments for 270/271 transactions and they have been unable to provide us an ETA as to when new enrollments will be accepted. We will post an update with … Continue reading →

PIV Red Flags and Epic Clients. Patient Identity Verification (PIV) Red Flag values are sent to Epic in ZMS-3 segment. To learn more, reference the following attachments. PIV Red Flags_Epic Patient Identity Verification (PIV) Red Flag Alerts – FAQ RedFlags_FAQ_Aug2015 … Continue reading →

Release Date: August 20, 2015 at 10:00p.m. CT Change Overview: Reminder – eCareNext – Scheduled Downtime – Tonight Tonight, 08.20.2015, eCareNEXT will be offline for 30-60 minutes during the regularly scheduled maintenance window beginning at 10:00p.m. CT. Coordination of Benefits Improves … Continue reading →

8.14.2015 – During our weekly deployment last evening, we added Red Flag alerts to our Patient Identity Verification (PIV) module that are now returned as part of the Experian address verification response. However, this has resulted in some minor Epic interface … Continue reading →

Patient Identity Verification (PIV) Red Flags Red Flag alerts will now be returned as part of the Experian address verification response.  Red Flags are alerts or warnings that identify patient information discrepancies (name, address, SSN, DOB) that may lead to … Continue reading →

Release Date: August 13, 2015 at 10:00p.m. CT Change Overview: Reminder: Patient Payment Estimator (PPE) Screen Changes – Available on 08.13.2015. The PPE interface will be updated this evening.  Documentation is provided on the Passport Dashboard and explains these changes … Continue reading →

Update NEBO Deductible Alerts 073015 On Thursday evening, July 30th, we will deploy updated versions of Epic NEBO deductible alerts. This update makes the alerts clearer to understand and enhances logic to give you the most accurate deductible information returned … Continue reading →

Release Date: July 23, 2015 at 10:00p.m. CT Change Overview: BatchSource Added normalization to all addresses that are parsed in the Eligibility and Coverage Discovery files. OrderSmart Global, Patient, and Workqueue Search: Added the ability to search with “Special Characters,” … Continue reading →

[07 23 2015 @ 11:31am CT] The eCare NEXT PPE backlog has been cleared, and the auto run feature has been re-enabled.  Your Estimates should be working normally.  If you continue to experience any problems, please reach out to Customer … Continue reading →

Wednesday, July 22 – The web portal for L.A. Care Health Plan is currently experiencing an authentication issue which has resulted in processing errors.   As necessary, we are monitoring this issue to identify a resolution.  There is no ETA at this … Continue reading →

July 17, 2015 – During the weekly deployment this evening, we will add new AlertBuilder functionality to the RQA Module.   This includes: Functionality for alert history by creating the AlertBuilder History Tab, which shows activation history of alerts, by user. A new … Continue reading →

Release Date: July 16, 2015 at 10:00p.m. CT Change Overview: Reminder – MyResponse Maintenance will occur this evening due to a server upgrade. MyResponse will be unavailable during this regularly scheduled maintenance window. We anticipate starting the upgrade around 9:00p.m. CT and completing all … Continue reading →

Release Date: July 9, 2015 at 10:00p.m. CT Change Overview: eCareNext Adds postback functionality and the ability to run benefits using multiple services types for clients who use specific business rules. Corrects an issue where users were not able to see when an eligibility transaction was … Continue reading →

Release Date: July 3, 2015 at 10:00p.m. CT Change Overview: Please note that due to the July 4 holiday, our weekly deployment this week will be limited to only critical items. eCareNext Corrects an issue where users cannot see an … Continue reading →

As of 8:31 p.m. ET,  UHC fixed their 278N issue related to the dx code submission process. You can continue to submit your UHC NOAs with free text diagnosis codes.” Wednesday, July 1 – UHC has indicated that a change was … Continue reading →

[6:30pm CT]  The OrderRite Authorization Image link issue within eCareNext is resolved. [5:00pm CT]  We are currently experiencing a processing issue for the OrderRite Authorization Image link from within eCareNext. Users will see the following message “An unexpected error occurred during the processing … Continue reading →

Tuesday, June 30 – Florida Medicaid Share of Cost has returned to normal processing.  We will continue to monitor this payer. Monday, June 29 – Florida Medicaid Share of Cost began experiencing processing issues which has resulted in approximately half of all inquiries failing … Continue reading →

Release Date: June 25, 2015 at 10:00p.m. CT Change Overview: Clearinghouse Corrected a response issue for TRICARE Overseas where the response indicated invalid search criteria. OrderRite Improved the daily billing extract and ABN notes reporting. IntelliSource Improved procedure for global … Continue reading →

Tuesday, June 16 – The payer Fox Everett Eligibility changed, which has resulted in processing errors.  As necessary, we have marked this payer down until new code can be deployed.  There is no ETA at this time.

Monday, June 15 – An “old” connection for Paramount Health Eligibility was discontinued and a “new” connection was moved into production.  This has resulted in authentication issues.  As necessary, we have marked this payer down until new code can be … Continue reading →

Update – We have made the necessary adjustments to accomidate the recent changes.  This payer is back up in production and is processing as normal. Friday, June 5 – The payer, Ambetter Eligibility changed, which resulted in all inquiries returning … Continue reading →

Release Date: June 11, 2015 at 10:00p.m. CTChange Overview: During this week’s regular maintenance window, we will be evaluating specific process and product improvements.  This evaluation is being performed to address the needs of our clients and will not be … Continue reading →

Release Date: June 04, 2015 at 10:00p.m. CT Important: During this regularly scheduled maintenance window, we will be performing database failover maintenance. The following products will be unavailable between 10:00p.m. to 12:00a.m. CT. This includes: Ecareonline, Patient Payment Estimator (PPE), … Continue reading →

Release Date: May 28, 2015 at 10:00p.m. CT Change Overview: eCareNext Corrects updated statuses reported by OrderRite that were not being reflected in eCareNEXT. Now populates payer in Work Queue with authorization detail windows. Improved event type handling within the … Continue reading →

Issue Summary Transaction (eligibility, alerts, estimates) processes were intermittently slower than usual or timed out. Timeline The first instances began at approximately 12:45 p.m. CT on Tuesday 5/26/2015 and ended at 2:30 p.m. CT on Wednesday 5/27/2015. Scope 6% of … Continue reading →

[05 27 2015 @ 4:25 pm CT]  Resolved – At 12:15 p.m. CT, our production control team was able to identify and correct an internal processing issue that may have resulted in slower than normal response times.  Again, we will continue to … Continue reading →

Resolved:  As of 4:00p.m. CT, processing has returned to normal.   We continued to monitor this issue as to avoid any reoccurrence.  We apologize for any inconvenience. We are currently researching a sporadic issue that seems to be causing slower than … Continue reading →

[06/05/2015 8A] Our developers have resolved the issues with Bankers Life & Casualty and Colonial Penn and both are now available for transactions. We apologize for any inconvenience caused. Bankers Life & Casualty and Colonial Penn are both currently down in … Continue reading →

The Mississippi CHIP (UHC) connection is no longer available. These members can be verified using United Healthcare Community Plan.

Release Date: May 22, 2015 at 10:00pm CT Change Overview: eCareNEXT – Work Queue global search. Previously, the search function looked at the search input value at the beginning, middle, and end. However, to improve the search results (and thus … Continue reading →

Deductible and out of pocket remaining amounts for Cigna members may not be accurate in the Cigna eligibility response. Passport is working with Cigna to get this issue resolved as soon as possible. We apologize for any inconvenience this may … Continue reading →