ISSUE: Duplicated United Healthcare medical claims
- Kenley Money
Number | 0154 |
|---|---|
Submitting Entity (SE) | 95446, 79413A, 71420 and 79413D |
Add Date | May 3, 2024 |
Update Date | May 10, 2024 Feb 7, 2025 |
Update | Added date range. Included in February 2025 Data Tips email. |
Description | A system error occurred in the submitter extraction process for United submitting entities 95446 and 79413A causing extensive claim line duplication. The error created multiple copies of a claim line and then appended sequential claim line numbers. For example, if claim 123 had two services, two records should have been produced one with claim number (MC004) = 123 and claim line number (MC005) = 1 and the second with claim number (MC004) = 123 and claim line number (MC005) = 2. Instead the rows were duplicated randomly and claim 123 had as many as 10 rows with claim lines 1 through 10. It is recommended that medical claims where MC001 in ('95446','79413A' ) not be used when MC017 is between 2022-10-01 and 2023-06-30. These data will be resubmitted in May 2024 for inclusion in the next APCD build. |
Active/Resolved | Active |
Action / Resolution |
|
Category 1 | Versioning |
Category 2 | Data Quality |
Tip / Issue | issue |