UCARE... BS

Its the usual Friday night. Half hour before my shift is over and shit hits the fan. As usual.

Nice guy walks up to the counter and asks if his doctor has called in his prescriptions yet. I look at my pile and see he's next in line, so I tell him it'll be a couple minutes.

I submit it to Minnesota Welfare.

REJECTED

I look at the reject and it says "PPHP UCARE" which means he has UCARE instead of welfare.

[One of the states I work in has four medicaid plans. All of those have different ids and different groups. And people get switched plans monthly. Even if they are on the same plan, every month the state will change the group number. Its a joy]

I ask him if he has a new card, and he gives it to me.... and UCARE card. Imput all the proper info on the card, submit the claim and...

REJECTED

WTF I go. I double check all the numbers and everything matchs up. I go into the reject screen and it says "Member ID not found".

Bullshit. I'm looking right at the card (dated current even). I monkey around with it, get several more rejects. Finally I call a different store and they suggest trying another group (one not on the card). Once again

REJECTED

Ah but there is light at the end of the tunnel. The reject states that "Patient is not covered". Now MN-ITs (where we verify which MA coverage the patient has) said he had UCARE. The Welfare reject said he had UCARE. Patient said his case worker just yesterday said he had UCARE. But UCARE disagrees.

Of course they're only open from 8am-5pm M-F, so the guy was SOL. We gave him some tablets to get through to Monday when we can finally get a hold of someone. In all likelihood he has coverage, theres just a glitch somewhere that says he doesn't. He was at least very patients and polite with us over the whole ordeal.

Minnesota is such a pain in the ass.... least I'm going to the bar tonight.