Monitoring - Please be advised Utah Medicaid has provided the below notice related to PRISM Trading Partner Agreement Requirements:
All Utah Medicaid providers must have completed their Trading Partner Agreements in the PRISM enrollment steps called: Mode of Submission/EDI Exchange, Associate Billing Agent, and 835/ERA Enrollment Form. These must be completed with current submission and receipt Trading Partner Number (TPN) information to ensure claims and other HIPAA transactions are accepted into the PRISM system for processing. If these steps are not completed accurately, files will be rejected as "Entity not approved as an electronic submitter." For verification, in PRISM, providers must check the Associate Billing Agent step for approved Trading Partner Numbers (TPN) and the associated HIPAA transaction types.
Feb 28, 2023 - 16:57 MST
Utah Medicaid has identified some defects that have prevented the 835 Remittance Advices (RAs) to generate. The defect is being worked on, we have created “paper RA’s” which have been loaded as PDF documents, viewable in My Inbox or in the Attached Documents of the adjudicated claim(s).
We thank you for your patience as we resolve this issue. For the published electronic remittances that were delivered, the Trading Partner Number (TPN) in the Control segments (ISA06 & GS02) contained a TPN of HT000004-004. This TPN is traditionally used for Testing as outlined in the Utah Medicaid Companion Guides. This may have caused the transaction to fail for some providers. All 835's were reissued with the correct TPN early this morning no other changes were made, 4/13/2023.
Apr 13, 2023 - 17:41 MDT
Monitoring - Utah Medicaid has advised the following:
276/277 and 837's: Providers can submit electronic claims (837) and claim inquiries (276/277) up to March 8, 2023, by 5:00 pm MST. Any electronic claim inquiries submitted after that date/time will be processed after the freeze period ends. UHIN will hold electronic claims (276/277) and submit to Medicaid for processing after the freeze period ends. Any files submitted after March 8th, must be in PRISM formatting. 270/271: Providers can submit electronic eligibility inquiries (270/271) up to April 1, 2023, in Legacy format, by 5:00 pm MST. Any electronic eligibility inquiries submitted after that date/time will be processed after the freeze period ends. UHIN will hold electronic eligibility inquiries (270/271) and submit to Medicaid for processing after the freeze period ends. Any files submitted after on or after April 2, 2023, must be in PRISM formatting.
Feb 28, 2023 - 19:28 MST
The "degraded performance" and "under maintenance" states are not considered for uptime calculations. While UHIN does track degraded performance internally (ie. slower than normal system performance) these times are not calculated by the status page.