Change Healthcare Cybersecurity Incident
Updated: April 25, 2024
On Feb. 21, 2024, Change Healthcare (CHC) experienced a significant cybersecurity incident, disrupting its operations. This incident has impacted aspects of Johns Hopkins Health Plans operations and continues to be closely monitored by our Information Technology leadership and executives. We have implemented heightened security protocols to mitigate potential risks to our providers and members.
Background
Johns Hopkins Health Plans continues to work toward resolutions as a result of the cybersecurity incident experienced by Change Healthcare.
One of the primary impacts nationally has been the disruption of claims submission and claims payment services, creating financial uncertainty for many providers.
Johns Hopkins Health Plans is impacted by this incident and is acting swiftly to support its network providers with up to date information and alternative solutions.
General Impact
Electronic claims submission and payment receipt status matrix
| Line of Business | Claim submission is through CHC | Claim submission is NOT through CHC | Payment/835 remits are through CHC |
Payment/835 remits are NOT through CHC |
| Advantage MD | Impacted | Not Impacted | Impacted | Impacted |
| EHP | Impacted |
Not Impacted |
Impacted |
Not Impacted |
| Priority Partners | Impacted |
Not Impacted |
Impacted |
Not Impacted |
| USFHP | Impacted |
Not Impacted |
Impacted |
Impacted |
- For impacts to Johns Hopkins Health Plans’ ability to receive claims submissions and process remits and payments, see the appropriate sections below.
- Apart from services connected to Change Healthcare, no other systems or processes within Johns Hopkins Health Plans are affected at this time. Providers can still make benefit and eligibility inquiries and submit prior authorization requests. Access to our provider portal is not impacted; providers are strongly encouraged to access the Availity and HealthLINK portals for member eligibility and benefit verifications.
- Authorization submissions are not currently impacted by this incident. InterQual is available, and we are operating business as usual for authorizations and medical necessity determinations. Providers should not delay authorization requests and should submit them following standard procedures. However, if a provider failed to request authorization related to the Optum/Change Healthcare cybersecurity incident, Johns Hopkins Health Plans will provide the opportunity to request a retrospective authorization following normal protocols and without penalty. In addition, providers will continue to be afforded opportunities to appeal medical necessity determinations.
Claims Submission
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Johns Hopkins Health Plans cannot currently receive any claims that are submitted through Change Healthcare.
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Johns Hopkins Health Plans can receive claims from all other clearing houses except Change Healthcare at this time. Providers can use any alternative clearing house as usual. Claims for Priority Partners, Employer Health Programs and Advantage MD can be submitted through our Availity portal; Claims for US Family Health Plan can be submitted through our HealthLINK portal.
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Yes, Johns Hopkins Health Plans will accept paper claims. However, paper claims must be manually entered, which may cause delays in claims adjudication/payments versus electronic claims submission.
Please mail paper claims directly to:
EHP
P.O. Box 4227
Scranton, PA 18505Priority Partners
P.O. Box 4228
Scranton, PA 18505Johns Hopkins Advantage MD
P.O. Box 3537
Scranton, PA 18505Johns Hopkins Health Plans
PO Box 830479
Birmingham, AL 35283
Attn: USFHP Claims Submission -
No. Claims submitted through Feb. 20, 2024 have been sent to Johns Hopkins Health Plans.
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There is no impact to the adjudication of claims that were already in process before the Change Healthcare cybersecurity incident of Feb. 21, 2024.
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Johns Hopkins Health Plans will extend limits for timely filing and claims adjustments for 60 days from when connections are restored for Change Healthcare.
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No. Providers may continue to submit claims disputes and medical necessity appeals through the normal channels. The claims reconsideration timelines are based on date of payment and are therefore not impacted by this incident. Medical necessity appeal timelines are based on date of denial for medical necessity.
Claims Payment
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Electronic claims payments and remittances for Priority Partners and Employer Health Programs (EHP) can be processed, as long as a provider uses a clearing house other than Change Healthcare for claims submission and remit services.
Johns Hopkins Health Plans works with Optum/Change Healthcare for electronic payment and remittance services for US Family Health Plan and Advantage MD. As a result, we are currently unable to process electronic claim payments and remittances for US Family Health Plan and Advantage MD.
Johns Hopkins Health Plans has engaged PNC Healthcare and ECHO Health, Inc., to provide new electronic methods for claims payment and remittances via their Claim Payments & Remittances (CPR) service for Advantage MD and USFHP. The transition from Change Healthcare to this CPR service will take place for Advantage MD first with USFHP to follow (specific date to be set soon). Once implemented, payments for Advantage MD and USFHP will only be issued using this CPR service — payments are already issued this way for Employer Health Programs and Priority Partners.
Providers that are already enrolled with PNC/ECHO for Employer Health Programs (EHP) and Priority Partners do not need to take further action. Providers not enrolled with PNC/ECHO for EHP and Priority Partners, please follow the important instructions below to ensure you receive payment for Advantage MD and USFHP as soon as this new CPR service is available. We recommend providers enroll now, as the EFT enrollment process takes 7-10 business days once the request is submitted. We also recommend that providers call Advantage MD Customer Service at 877-293-5325 or USFHP Customer Service at 800-808-7347, as applicable, to confirm the remittance address and fax number on file, as the first payment after the transition will be sent via fax or mail if providers do not complete early enrollment for EFT.
To learn about payment options and any next steps needed to receive your preferred method of payment, view our Provider Update.
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Johns Hopkins Health Plans is exploring payment advances as a way to support our providers. We will provide more information when available. Please reach out to your Provider Relations contact.
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Currently, any remits for claims that processed through Change Healthcare (all USFHP and Advantage MD claims, as well as Priority Partners and EHP claims processed prior to Sept. 1, 2022) are not available to Johns Hopkins Health Plans Customer Service at this time.
Advantage MD remits for claims processed prior to Feb. 22, 2024 can be accessed in Availity.
EHP and Priority Partners remits for claims processed through PNC/ECHO after Sept. 1, 2022 are not affected and can be accessed as normal.
You may also access remit details via the HealthLink portal.
Additional Information and Assistance
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Optum Financial Services is offering temporary funding assistance to provider organizations affected by the payer system outage. Eligible providers can register at http://www.optum.com/temporaryfunding.
This information has been provided by the United HealthGroup.
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Availity has prepared their own Frequently Asked Questions on their response to the Change Healthcare Cybersecurity event to assist providers on processing transactions.
This information has been provided by Availity.