Update – March 7th, 2024

We are pleased to share some positive developments as we navigate through the challenges posed by the Change Healthcare/Optum outage:

1. Efficient Claim Resubmission: We’ve successfully transitioned all claims previously on hold (Temp_Hold) due to the outage. These claims are now in the ‘Valid’ category and have been resubmitted wherever we’ve identified viable alternative routes.
2. Expansive Payer Network Update: Our team has diligently updated the submission pathways for over 600 payers, ensuring that claims are processed through these new, effective channels.
3. Ongoing Strategic Efforts: Our commitment to resolving this issue is unwavering. We are actively exploring and establishing alternative pathways for the remaining payers, ensuring a comprehensive and robust solution to this challenge.
4. Significant Progress in Claim Submissions: Despite the unexpected outage, we’ve made remarkable progress in claim management. To date, we’ve successfully submitted 75% of the total insurance claims that were impacted by the outage.

We appreciate your patience and understanding as we continue to work tirelessly to mitigate the impact of this outage. Our team is dedicated to maintaining the highest standards of service and efficiency during this period. Stay tuned for further updates as we forge ahead.

Update – February 29th, 2024

As we continue to navigate the ongoing system outage at Change Healthcare, we want to provide you with the latest updates and address some new questions that have arisen. We understand the challenges this situation presents and appreciate your continued patience and understanding.

Persisting Problems

• Change Healthcare, the largest healthcare clearinghouse in the country, has been experiencing an outage since February 21, 2024. This is a nationwide issue, affecting not just our services but many others across the country.

• Claims, Electronic Remittance Advice (ERA), eligibility checks, and paper patient statements remain queued for submission as soon as Change Healthcare resolves the issue. We assure you that electronic statements are still being sent out without interruption.

• This outage is causing delays in payment postings and our ability to follow up on claims. We are preparing for a significant backlog of claims once the problem is resolved, but rest assured, our team is ready to handle this efficiently.

New Updates

• In response to this outage, we are actively exploring alternative solutions. We are attempting to reroute claims through different clearinghouses.

Frequently Asked Questions

Q: Why are some of my claims in ‘Temp Hold’?

A: Claims are placed in ‘Temp Hold’ as a proactive measure due to the ongoing outage at Change Healthcare. This status is applied to claims that we are currently unable to submit through the usual channels. The ‘Temp Hold’ allows us to effectively identify, manage, and prepare these claims for alternative submission methods as soon as they become available. It’s a temporary step to ensure that your claims are securely held and ready for processing, minimizing any further delays once the system issues are resolved. We are actively working to transition these claims back to their valid status within the next day or two.

Q: How are Eligibility Services affected by the Change Healthcare outage?

A: Electronic eligibility services, which are provided by Change Healthcare, are included in the disruption caused by their system outage. This means that there may be delays or temporary unavailability in verifying patient eligibility through their system. We are monitoring the situation and will provide updates as they become available.

Q: Why am I seeing payments in my bank account that are not reflected in the system?

A: The payments you are seeing in your bank account are for claims that have already been processed and paid out by the payers. These transactions are continuing as usual. However, due to the ongoing outage at Change Healthcare, there is a disruption in the transmission of Electronic Remittance Advice (ERAs). Our system relies on these ERAs to post payments and generate accurate invoices. Without the ERAs, there is a temporary disconnect between the payments received in your bank account and what is currently reflected. We are aware of this issue and are working to resolve it as soon as the ERAs are back online. In the meantime, please be assured that your payments are secure, and we will update the system accordingly once the ERAs are received.

Invoicing

You might notice payments in your bank account that are not reflected due to the ERAs not being sent. This discrepancy is because payments for claims already received by payers are still being processed.

Consequently, your invoice this month might be lower than expected, with subsequent invoices potentially being higher as we catch up with payment postings, eventually achieving balance. If you encounter any issues reconciling your accounts, please reach out to our team for assistance.

Looking Ahead

The longer this disruption continues, the greater the backlog in the queue for submission and potential rejections once service is restored. We are committed to keeping you informed and minimizing the impact on your business.

We sincerely apologize for any inconvenience caused and are working tirelessly to find solutions and keep your operations running as smoothly as possible during this challenging time. For any further queries or concerns, please feel free to contact us.

Thank you for your continued trust in our services.