In late February, Change Healthcare, a unit of UnitedHealth Group (UHG), was impacted by a cyber security incident. Change Healthcare is used by provider offices around the country for claims submission and other administrative functions. The attack has affected billing and care-authorization portals, with patients reporting delays in getting prescriptions and hospitals experiencing issues with processing claims, billing patients and checking insurance coverage for care.
The Kentucky Department of Insurance (DOI) has not yet received any complaints from providers on this issue, but is reminding physicians that the DOI website allows providers to submit electronic complaints.
Several other health plans have alternative methods to submit claims if the UHG cyber incident impacts claims submission:
Anthem Commercial and Medicaid: Providers may submit claims electronically through Availity on its provider website.
Passport by Molina: Providers utilizing Change Healthcare to submit claims to Passport prior to this outage may now do so via an alternate established connection with SSI Claimsnet, LLC (“SSI Group”) clearinghouse or another clearinghouse of their choice. Providers not directly utilizing Change Healthcare can and should continue utilizing their current clearinghouse for claims submission. Passport by Molina’s Availity Essentials provider portal solution was not impacted by this outage and remains available as another option to key in claims for submission. Providers can register with SSI Group for claim submission via the Claimsnet’s Provider Registration Form located online.
Aetna Better Health: Network providers who directly use Change Healthcare for EDI transactions for Aetna are encouraged to stay “digital first” and use one of their other business partners for electronic transactions until Change’s service interruption is resolved. Providers can also utilize their existing medical provider portal hosted by Availity.
WellCare: Providers can submit electronic claims to Wellcare via many alternative methods including other claims clearinghouses, the secure provider portal, fax or mail. WellCare’s preferred clearinghouse for electronic claims submission is Availity. To enroll, please visit Availity.com and/or call Availity Client Services at 1-800-AVAILITY (1-800-282-4548).
Humana: Providers are also asked to utilize Availity to submit claims during this time.
The Centers for Medicare and Medicaid Services have also announced a new opportunity for physicians impacted by the cyberattack and resulting disruptions with Change Healthcare to request advanced Medicare payments to help with cash flow disruptions. The details of the program, terms, and the steps needed to apply can be found in the links below.
CMS Statement – https://www.cms.gov/newsroom/press-releases/cms-statement-continued-action-respond-cyberattack-change-healthcare
According to the Kentucky Department of Insurance, Change Healthcare provided the following information yesterday:
- Electronic prescribing is fully functional.
- The Change Pharmacy Network is back online. They are still working on specialty coupons and infusion providers.
- For medical claims, they recommend their workaround, iEDI.
- Providers can go through the website to request information on iEDI and workarounds.
- The target date to restore medical claims functions is 3/18. ‘
- The target date for electronic payment functionality is 3/15.
- The UHC companies are offering three funding programs for providers: Optum, if the practice used Change to receive payments, a second Optum program for providers who have exhausted other options on a case by case basis, UHC funding for its provider partners, including dental, medical, and vision. The UHC funding is based on the difference between the provider’s normal claims payment levels and current claims payment levels.
