Change Healthcare Cybersecurity Incident and Its Impact to Ambetter

Fecha: 28/02/24

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’s members and provider network in several ways. 

As of now, Change Healthcare has not provided a timeline for resolution. To protect our members and providers, Ambetter fully disconnected system access to and from Change Healthcare on February 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 through Change Healthcare is currently down. Providers can easily submit electronic claims to Ambetter via many alternative methods including other claims clearinghouses, our secure provider portal, or mail. Our preferred clearinghouse for electronic claims submission is Availity. To enroll, please visit Availity Lifeline Resources for Change Healthcare's event and/or call Availity Client Services at 1-800-AVAILITY (1-800-282-4548). For step-by-step instructions for Availity, visit the resource page on our parent company Centene’s website at Centene.com/change-healthcare.html. Additional information on claims submission can be found in our Provider Manual located on our website at Ambetterofillinois.com/provider-resources/manuals-and-forms.html.

Reimbursement via Paper Check and Virtual Credit Card (VCC)

Some paper check and virtual credit card payment processes for Ambetter 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’s preferred ACH/EFT partner, PaySpan (now part of Zelis), has offered to help expedite the sign-up process for providers by calling 877-331-7154 or visiting PaySpan. 

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, 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 period of February 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 Relations representative or our Provider Services team at 855-745-5507 or visit Centene.com/change-healthcare.html.