Claims: Multiple CPIDS UnitedHealthCare West: Increase in the Rejections in Claim Level Responses
CollaborateMD Blog
Please read the following bulletin from UnitedHealthCare West.

Payers affected are:
CPID 3429 United HealthCare
CPID 3550 United HealthCare
CPID 3797 Definity Health
CPID 6535 Definity Health
CPID 2740 Pacificare of California - Encounters
CPID 8956 Pacificare of California - Encounters

Action Required: The Payable Claims for UnitedHealthcare West will need to be resubmitted by the submitter for processing.

Issue Reported by United HealthCare:

UNITEDHEALTHCARE SYSTEM NOTIFICATION

Date: 12/13/2012
To All:

This communication is to make you aware of an issue that has occurred at UnitedHealthcare West on December 10, 2012 - TBD.

You may experience an increase in the rejections listed below that you receive in the claim level responses for the EDI claim and encounter transactions submitted to UnitedHealthcare West.

STC*A3*90

A3: Claim/encounter cannot be processed according to plan provisions.
90: Entity not eligible for medical benefits for submitted dates of service

STC*A3*33

A3: Claim/encounter cannot be processed according to plan provisions.
33: Subscriber & subscriber id not found

At this time we do believe that the 270/271, 276/277 and 278 EDI transactions for UnitedHealthcare West may also be impacted due to this issue. The 271, 276 and 278 responses may return a higher number of Subscriber and subscriber ID not found.

SUBMITTER ACTION: We have determined that The Payable Claims for UnitedHealthcare West will need to be resubmitted by the submitter for processing.

We apologize for any inconvenience that this may cause your organization. If you have any questions you can contact our EDI Support Team via 800 842-1109 or EDI Issue Reporting Form for assistance.

Thank you,
UnitedHealthcare


If you have any questions, please contact Client Services at 1-888-348-8457, option 2.