WPS Health Insurance

Gateway Express Issues

WPS Health Solutions experienced system issues with Gateway Express claim file submissions on 01/15/2018. As a result, some claim files submitted were not immediately passed to the processing systems that day. Files that were impacted that day were submitted for processing on Tuesday 1/16/2018. File acknowledgements were routed to trading partners by Tuesday as well.

In addition to the file routing issue, we have experienced some other similar ongoing issues with our Gateway Express transaction submissions beginning in August 2017, including the following:

  1. Issue: Some claim file acknowledgements are not being returned timely to our trading partners.
    Update: We have identified the root cause of 999 transactions not being returned, and implemented a fix within the system on 1/10/2018. New claim file submissions will now receive this transaction. We continue to make progress toward validation that all new 277CA transactions are generated and sent. For trading partners that have contacted us, we are also working to generate the appropriate 999/277CA for claim files submitted previously that did not receive these acknowledgements.
  2. Issue: Some X12 837 claim files are not being passed to the claims processing systems.
    Update: We are working to identify root cause and have implemented additional front-end processes to remediate this issue. We continue to work to validate that all new accepted claim files/claims are appropriately processed.

We are also aware that some trading partners are receiving “time-out” errors when sending or retrieving Gateway Express transactions this week, and are working to resolve this issue as quickly as possible.

We appreciate your patience and assistance in helping us work through these issues, and apologize for the difficulties they have caused for our Gateway Express trading partners. We remain committed to moving forward with successful migration to WPS Gateway Express.