Read the latest information, learn how to submit claims and more.
On Wednesday, February 21, 2024, Change Healthcare, a third-party vendor used by providers and carriers across the U.S, reported a cyber security event that resulted in a network outage. Unfortunately, this outage has impacted their ability to support claims submission, payment, eligibility checks, and settlement services. Providence Health Plan accepts claims from providers submitted through Change Healthcare and some providers use Change to check eligibility for patients with Providence Health plan coverage.
Why it matters.
Change Healthcare is an electronic data interchange (EDI) vendor (or clearinghouse) utilized by many providers and carriers. Due to this outage, any electronic transactions delivered via the Change Healthcare platform are on hold. Enrollment and claim data cannot be transferred between payers, providers and pharmacies if Change is the only EDI vendor available to the provider.
What is affected?
PHP isn’t able to receive claims submitted through Change Healthcare. We are also unable to provide member eligibility information to providers though Change Healthcare.
What should providers do?
Update - March 29, 2024
Providence Health Plan is now live with Optum’s EDI workaround for providers. Please reach out to Change Healthcare to confirm you are set up to submit Providence Health Plan claims via the workaround.
Providence Health Plan payor ID - SX133
Providers should submit claims through an alternative EDI vendor. Please do not submit a claim via paper/fax. Claims cannot be submitted via Provlink.
Professional claims
Institutional claims
ERA Electronic Remittance Advice
PHP01
What’s next?
We are monitoring the situation closely and working diligently to ease the way of our provider partners and the members we all serve. Please bookmark this page and check back regularly for updates. Thank you for your patience.
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