Missing partially adjudicated claims data

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Beneficiary Claims Data API (BCDA) Community

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Sep 19, 2024, 3:23:43 PM9/19/24
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Hello REACH ACOs,

Our upstream data providers have identified an issue causing some partially adjudicated claims to be incorrectly labeled as SAMHSA-related and suppressed from your BCDA job results. Our teams believe this is limited to institutional claims and we are working to confirm the scope of impact including which claims have been withheld from job requests and for how long this issue has persisted.

This issue is limited to partially adjudicated claims data in the Claim and ClaimResponse resources. There is no impact to the EoB, Patient, or Coverage resources.

We will notify you as soon as we have more information to share on the teams' findings and progress towards resolution.

Thanks,
The BCDA Team

Beneficiary Claims Data API (BCDA) Community

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Sep 20, 2024, 2:51:34 PM9/20/24
to Beneficiary Claims Data API (BCDA) Community
Hello REACH ACOs,

Our upstream data providers have resolved the issue causing some partially adjudicated institutional claims to be incorrectly labeled as SAMHSA-related and subsequently suppressed from your BCDA job results which led to an underreporting of underreporting of partially adjudicated institutional claims.

As a reminder, this issue was limited to partially adjudicated institutional claims data in the Claim and ClaimResponse resources. There was no impact to the EoB, Patient, or Coverage resources.

After an thorough review, we have determined that this issue has existed since the launch of BCDA's partially adjudicated claims enhancement in May 2023.  You can now run a new job request, omitting the _since parameter, in order to receive a full data load that includes all prior missing Claim and ClaimResponse resources.  Please note that partially adjudicated claims which have not been updated in the past 60 days are not available via BCDA.

Review this announcement for more information on the availability of partially adjudicated claims data in BCDA.

We apologies for the troubles this incident has caused. Please reach out with any questions or feedback.

Thanks,
The BCDA Team
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