Change Healthcare Outage Overview
On Feb. 21, Change Healthcare experienced a cybersecurity incident that has created a service disruption impacting payers, providers and pharmacies nationwide, including Centene and some of its subsidiaries.* Recognizing the impact of the outage, Centene took immediate and decisive action to preserve continuity of care for our members and patients, while seeking to reduce the disruption on our providers. We immediately initiated a provider outreach support campaign, launching this website to help providers navigate this evolving situation with routinely updated reference materials, tips and step-by-step guidance to address challenges related to processing claims, checks, provider advances and chart retrieval. Our ~700 provider engagement team members nationwide are proactively making calls, checking in on providers and working tirelessly to help them resume normal course operations as quickly as possible.
This page is broken down by topic and will be routinely updated as the situation evolves. Caring for our members, providers, customers, and local communities is core to our mission. We thank you for your patience and apologize for any inconveniences resulting from this situation.
Members
Ensuring access to care for our members following the Feb. 21, 2024 Change Healthcare cybersecurity incident is our top priority. If you are a member who has been impacted by this incident, please contact the health plan in your state.
Thank you for your patience as we work through this evolving situation.
Providers
We understand that providers who use Change Healthcare (Emdeon Business Services) for claims submission are experiencing challenges resulting from the outage. Our preferred clearinghouse for electronic claims submission is Availity, and their base Essentials plan is free for Centene providers. To enroll, please visit Availity's website and/or call Availity Client Services at 1-800-AVAILITY (1-800-282-4548). Step-by-step instructions for Availity, are outlined below:
Availity Lifeline Resource Guide, FAQs and Training Demos
How to Register with Availity’s Provider Portal (PDF)
Timely filing rules and potential extensions will be dictated by local regulators and CMS. We highly encourage providers to use the resources available to submit claims timely, and to not wait. If you have concerns with timely filing, please work with your Provider Engagement representative.
Providers seeking to check a member's eligibility can do so through their normal process, unless they utilize Change Healthcare for eligibility checks. Centene’s subsidiary health plans also offer multiple ways for providers to easily check member eligibility, and detailed instructions can be found in the provider manuals on the health plan websites. There has been no impact on Centene's ability to check a member's eligibility.
Providers who receive payments through paper checks and virtual credit cards may have been impacted by the Change Healthcare outage (providers receiving payments through an ACH process are not impacted).
We are currently working through alternate ways to send out impacted paper checks outside the Change Health process. An alternate way to speed up your payment process is to set up an ACH. You can sign up with PaySpan (now part of Zelis) to receive ACH payments from us at www.payspanhealth.com.
We recognize that finding alternative ways to submit claims is not always immediately possible. As a result, providers may be experiencing extreme financial hardship (e.g., risk in making payroll) resulting from the Change Healthcare cybersecurity incident that could impact their ability to continue operating and, ultimately, limit access to care for our members. Preserving access to care for our members and supporting our providers remains our top priority.
As an organization, our criteria for considering cash advances largely aligns with CMS’ approach on accelerated fee-for-service payments, as outlined in CMS’ March 9, 2024 Change Healthcare/Optum Payment Disruption (CHOPD) Accelerated Payments to Part A Providers and Advance Payments to Part B Suppliers Fact Sheet. Our provider advance program is for a 90-day term, with zero interest, and requires completion of a two-page agreement. Centene will assess all requests for cash advances on a case-by-case basis.
Providers experiencing financial distress should reach out to their local Provider Engagement team for immediate support.
Change Healthcare performs retrieval of medical records for several of our programs, such as HEDIS® and Risk Adjustment. You may have received a request via phone or fax from Change Healthcare on behalf of Centene or its subsidiary health plans, where you either scheduled appointments or provided medical records. Change Healthcare is unable to honor any fulfillment requests at this time; however, Centene will be employing two of our existing medical record retrieval vendors, Datavant (formerly Ciox) and Datafied, to satisfy these prior commitments.
These retrievals are required to report on clinical quality measures and diagnosis data to Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) and the National Committee for Quality Assurance (NCQA). We ask that you please honor the same commitment dates for these vendors, even if you have already committed to providing medical records to Change Healthcare. If you have provided medical records from the time period of Feb. 19, 2024 to current, you may be asked to provide these medical records again.