Provider Alert: Change Healthcare Cybersecurity Incident and Its Impact to Ambetter of Tennessee

Date: 03/01/24

On February 21, Change Healthcare, a software and data analytics subsidiary of UnitedHealth Group’s Optum unit, experienced a cybersecurity incident that has impacted its network and operations. The cybersecurity incident has created a service disruption impacting Ambetter of Tennessee’s members and provider network in several ways.

As of now, Change Healthcare has not provided a timeline for resolution. In order to protect our members and providers, Ambetter of Tennessee fully disconnected system access to and from Change Healthcare on Feb. 21. We are working on multiple solutions to restore provider functionality and ensure continuity of care for our members. We will continue to provide updates as this situation evolves.

Electronic Claim Submission 

The ability to electronically submit claims to Ambetter
of Tennessee through Change Healthcare is currently down. Providers can easily submit electronic claims to Ambetter of Tennessee via many alternative methods including other claims clearinghouses, our secure provider portal, and mail. Our preferred clearinghouse for electronic claims submission is Availity. Please enroll by visiting availity.com/Essentials-Portal-Registration and/or calling Availity Client Services at 1-800-AVAILITY (1-800-282-4548). Visit the Availity Lifeline page at availity.com/availity-lifeline-self serve-resources for step-by-step instructions. Additional information on claims submission can be found in our Provider Manual located on our website at ambetteroftennessee.com.

Reimbursement via Paper Check and Virtual Credit Card (VCC)

Some paper check and virtual credit card payment processes for Ambetter of Tennessee have been disrupted due to this incident. We apologize for any inconvenience this causes. Please know we are working quickly to implement a new process to ensure payments are operational as soon as possible. An alternate way to speed up your payment process is to set up an automated clearing house (ACH) for electronic funds transfer (EFT). Ambetter of Tennessee’s preferred ACH/EFT partner, PaySpan (now part of Zelis), has offered to help expedite the sign-up process for providers by calling 1-877-331-7154 or visiting payspanhealth.com. 

Chart Retrieval

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 Ambetter of Tennessee, where you either scheduled appointments or provided medical records. Change Healthcare is
unable to honor any fulfillment requests at this time; however, we 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.

Thank you for your patience and partnership as we navigate this situation. We apologize for any inconvenience in this matter. If you have any questions, please contact your Provider Engagement representative or our Provider Services team at 1-833-709-4735 or visit centene.com/change-healthcare.