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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: 

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.