ISSUE: Duplicated United Healthcare medical claims

Number

0154

Submitting Entity (SE)

95446, 79413A

Add Date

May 3, 2024

Update Date

May 10, 2024

Update

Added date range. Included in May 2024 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