Support
 

Waystar: Erroneous Claim Rejections — Medicaid Ohio (SKOH0) and Affiliated Payers

Waystar has made us aware that on Tuesday, May 2, 2023, Ohio Medicaid Enterprise System (OMES) EDI implemented a change which caused claims to erroneously reject for E181 — Invalid affiliation between Rendering and Billing provider. Impacted claims would have produced an 824 transaction and HTML report with a reject code of E181. 

The issue was caught immediately and reversed on Wednesday, May 3, 2023. Claims submitted during the duration between May 2, 2023, 8:00 PM Eastern Time (ET) through May 3, 2023, 5:00 PM ET would have received rejects for invalid Rendering and Billing provider affiliation in error. 

Payers Affected: 

  • Medicaid Ohio (SKOH0)       
  • Medicaid Ohio — Amerihealth Caritas Ohio (35374)
  • Medicaid Ohio — Amerihealth Caritas Ohio – Transportation Only (42435)
  • Medicaid Ohio — Anthem EyeMed Vision (SKOH10)
  • Medicaid Ohio — Anthem Ohio Medicaid (SKOH5)
  • Medicaid Ohio — Buckeye Envolve Vision (SKOH7)
  • Medicaid Ohio — Buckeye Ohio Medicaid (SKOH3)
  • Medicaid Ohio — Caresource Ohio – Vision (SKOH6)
  • Medicaid Ohio — Caresource Ohio Medicaid (SKOH2)
  • Medicaid Ohio — Humana EyeMed (SKOH9)
  • Medicaid Ohio — Humana Ohio Medicaid (61103)
  • Medicaid Ohio — Molina March Vision (SKOH8)
  • Medicaid Ohio — Molina Ohio Medicaid (SKOH4)
  • Medicaid Ohio — United Healthcare OH Medicaid (88337)
  • Medicaid Ohio — United Healthcare OH Medicaid – Vision (83572)

Waystar Action Required by Client:

Waystar requires that clients resubmit any claims originally submitted between May 2, 2023, and May 3, 2023, receiving rejection error code E181 with a message similar to:

“E181RENDERING PROVIDER AND BILLING PROVIDER AFFILIATION HAS NOT BEEN ESTABLISHED (A3:585:PR)”

If you have any questions regarding this notice, please contact our Support Team.

 

RELATED ARTICLES

Waystar: Electronic Remittance Advice (ERA) Processing Delay: November 22–28, 2023

Waystar has made us aware of an electronic remittance advice (ERA) processing delay in…

Electronic Case Reporting (eCR) Update

If your practice is not attesting to MIPS or the Promoting Interoperability (PI) category…

gGastro® Cloud Update: Sunday, December 3, 2023, 12:01 AM – 8:00 AM ET

We plan on updating our gGastro® cloud clients to the latest version of gGastro…