Blue Cross VT Response: Change Healthcare Cybersecurity Incident

Change Healthcare is one of the largest clearinghouses for processing electronic claims and other healthcare business transactions. On February 21, United Health Group, Change Healthcare’s parent company, reported that it was the target of a cyber security incident and that it had taken most of its applications offline. Change could not post claims (837) files and bulk eligibility verification (270/271) transactions.

Upon learning of the incident, Blue Cross Vermont immediately stopped using Change’s services to safeguard our systems and data.

Although Change Healthcare has worked to restore claims and clearinghouse services, Blue Cross Vermont has not reconnected to Change for claims submission (837), bulk eligibility transactions (270/271), or transfer of electronic provider vouchers (835).  

Even if you do not use Change directly, you may still be impacted by this outage. Change’s network processes about half of all medical claims in the U.S. Many practice management systems rely on Change for some processes in the background. We recommend talking to your practice management system provider to determine the impact on your practice.

If you were expecting to get a claims payment from us and it has not yet arrived, you may be affected. Please check with your claims software vendor for more information.

A number of professional associations are providing information on the incident and may have recommendations and other resources for practices like yours on what to do. The following is a sampling of webpages reporting on the incident:

• American Hospital Association
• American Osteopathic Association
• American Academy of Ophthalmology

Change Healthcare has also published a webpage with answers to frequently asked questions.

Blue Cross Vermont is taking several actions to help reduce the impact on providers:

• Blue Cross Vermont has added Availity to the list of claims clearinghouses that we’re connected to for submitting your 837 transactions. Your practice will need to contract with Availity, if you are not already. Please visit Availity’s website for more information.
• We have compiled a list of alternative claims clearinghouses connected to Blue Cross Vermont – see "Alternative Clearinghouses" below.

We are monitoring information released by the U.S. Department of Health and Human Services. At this time Blue Cross Vermont is not making advanced payments to providers, but we are continuing to monitor the situation. We strongly encourage providers to work on long-term solutions to the Change Health Care outage. 

Your practice management system provider may be able to provide advice on the potential to leverage another clearinghouse with connections to Blue Cross Vermont. They will be able to tell you which ones they support and what would be involved in making the transition. Here is a list of the other clearinghouses supported by Blue Cross Vermont for the transmission of 837 and 835 transactions.

Note: Availity is only configured to send 837 transactions.

Our Electronic Data Interchange (EDI) department is available to answer questions you have about electronic submissions. You can contact them Monday through Friday, 8 a.m. – 4:30 p.m. at (800) 334-3441 option 2, or by e-mail at ecommercesupport@bcbsvt.com.

Here is a summary of the tools and resources currently available to help Blue Cross Vermont providers. As we develop additional tools, this section will be updated.

Submitting claims and checking claims status

Here are some things you should know: 

• Please only submit claims to us once, either via paper, fax, or through an electronic option. Submitting the same claim multiple times will cause processing delays.
  • Note: Claims will not appear in the Provider Resource Center immediately upon submission.
• If you choose to submit paper claims, processing times may be delayed.
• You can determine claims status through our Provider Resource Center. 
• You can determine claims status by calling Provider Inquiry at the phone numbers above.

Checking member’s eligibility and benefits

• Use the Provider Resource Center to submit eligibility requests. Remember for BlueCard and FEP members who are not with Blue Cross VT, use the real-time eligibility link.
• Contact the appropriate customer service team:
  • Blue Cross VT member – (800) 924-3494
  • FEP member – (800) 328-0365
  • BlueCard member – (800) 676-2583, then enter or speak the member’s prefix

Electronic provider voucher and remittance advice

• Electronic fund transfers:
  • There is NO impact to electronic fund transfers (EFT). They will occur as usual.
  • If you are not receiving an electronic remittance advice (ERA/835) from Change Healthcare, it does not mean you are not being paid.
• For claims submitted to Blue Cross VT:
  • Claims will be paid and processed by electronic fund transfer (EFT) or paper check (based on how the provider is set up to receive payment from us).
  • EFT’s are deposited on Friday
  • Paper checks are mailed on Friday
• Provider voucher: 
  • We encourage you to review your provider voucher on the Provider Resource Center and check in with your bank. 
  • A PDF version of your provider voucher can be located on the Provider Resource Center under the provider voucher link.
• 835 (ERA):
  • The 835 will not be available if you have Change Healthcare pick up and translate for your practice.  
  • We have provided a list of alternative claims clearinghouse vendors that are connected to us. See the Alternative Clearinghouses section above for more details. 

• Contact your claims submission software vendor and ask how the Change Healthcare incident affects them.
• Ask the software vendor where they send the claims, and if Change Healthcare is part of the transmission process.
• Talk to your EMR vendor and ask similar questions as above.

Our HEDIS data collection is on hold until further notice. If you receive a HEDIS request for medical records for a Blue Cross VT patient from anyone, please do not release the medical records and contact the provider relations team (888) 449-0443, option 1. We will post an updated notice once we are ready to resume.

Change Healthcare is engaged with cybersecurity experts and law enforcement. At this time, Change is investigating this incident and impact to any member data has not been determined. Blue Cross and Blue Shield of Vermont is monitoring the situation closely as the incident and impact investigation is ongoing.