- This topic has 8 voices and 10 replies.
-
Posts
-
Hi Ya’ll,
I’m having a TERRIBLE time getting paid on VFC admin fee. I just keep getting rejected saying not a covered charge. This particular one was denied “inappropriate identifier” I’m using the SL code. Has it changed? Is there another one? I have literally called 7 different numbers and they just tell me it’s denied and not a covered charge but can NOT tell me why.
Brittany
I talked to MO Healthnet and my HealthyBlue Rep, and they both said this is an issue with Healthy Blue. They are supposed to be working on fixing the problem, and we shouldn’t have to do anything on our end. Fingers crossed, this gets resolved soon!
BCHD is in the same boat. We have amassed a file box FULL of claims we will have to rebill once they figure out what they are doing… we already asked them about things being done timely, and they said since it was their issue it should be okay. But we shall see. But really by the time we provide the service and bill it twice or three times we aren’t making anything…
My provider rep said we should keep billing as usual and will probably get more denials. Once Healthy Blue fixes the problem, she stated Healthy Blue will pull our denied claims and reprocess them. I am keeping track of my denied immunizations to make sure they pay all of them once it’s fixed.
https://provider.healthybluemo.com/docs/gpp/MO_CAID_ProvContactListUpdateFINAL.pdf?v=202107151757
This link should take you to the page of reps. Ours is Ronald Caradine. He was formerly with Missouri Care and he can be very helpful.
Paula
Anytime you have unresolved issues with any of the Medicaid plans call MC+ Contract Compliance and file a complaint. 573-526-4274 or 573-522-9859. This office will get these issues resolved.
emomed should give you the ID of the patient if you have first last name and birthday with date of service
I look the Healthy Blue ID numbers up on Availity.com. Take the DCN from Emomed and add CBM in front of the DCN on the eligibility page and it will give you the Healthy Blue ID #. There are a few other things you need to enter like provider, and patient DOB.
Thank for reply. Thats what I have been doing but yesterday on Availity it keeps saying Invalid/Missing Subscriber/Insured ID no matter how I enter it. Thought maybe they changed something.
- You must be logged in to reply to this topic.