Change Healthcare Outage and Impact

The recent cyberattack on Change Healthcare has seriously disrupted healthcare providers’ operations. In response, the Benefit Funds are actively engaged in supporting providers through the following measures:

• Claims submission clearinghouse:The Benefit Funds are now using Inovalon Provider as the claims clearinghouse. For providers using a clearinghouse other than Inovalon Provider, your claims will be transmitted to the Benefit Funds without your needing to take additional action. Please note our payer ID# 13162.
• Timely claims submission: The Benefit Funds will continue to honor claims submitted within 365 days of the date of service or discharge.
• Submission of clinical information for appeals: Providers have up to 180 days from the date of denial or payment to submit claims for reconsideration and to appeal adverse determinations. 
• Verification of eligibility: Providers should continue to verify eligibility by visiting the NaviNet provider portal, calling the Interactive Voice Response (IVR) System at (888) 819-1199 or calling (646) 473-7160 to speak with a Benefit Funds representative. The Benefit Funds are working to resume online batch eligibility verification through an 834. The Benefit Funds will continue to deny claims for members who are not eligible at the time of service.
• Prior authorization requests: Providers should continue to submit authorization requests as indicated on the Benefits Funds’ Prior Authorization page.
• Provider payments: The Benefit Funds have resumed payments to providers. Payments will be issued by paper check and mailed to the address on file. Please allow additional time to receive payments as the Benefit Funds transition back to the regular payment cycle. The Benefit Funds are working to resume EFT payments.
• Provider remits: EOPs will be included in the mail with your paper check. ERAs will be available to providers who had an established prior ERA connection and will temporarily be issued by Inovalon Provider or your intermediary clearinghouse.

If you have any questions, please review the Benefit Funds' FAQs.