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Welcome UCare Providers

Change Healthcare/Optum outage

Page last updated April 16, 2024

Change Healthcare is experiencing a nationwide network interruption related to a cyber security issue that started Feb. 21, 2024. UCare is monitoring this evolving situation and will update the information on this page as we learn more. Please check back regularly.

Recent changes:

  • April 16, 2024 - Within the “Remittances” section, added clarity on when providers will receive 835s based on the date they or their clearinghouse enrolled with Availity.
  • April 16, 2024 – Within the “Remittances” section, added information about duplicate claim denials.
  • April 5, 2024 – Within the “Claim submissions” section, added more detail to the information about extending timely filing by 30 days.

Impact to UCare systems

The following electronic data interchange (EDI) transactions are impacted by the outage:

  • 837s/277CA - Electronic Claims/Claims Response - Providers may check individual claims through UCare’s Provider Portal. Providers who are enrolled with Availity or whose clearinghouse is enrolled with Availity are receiving transactions.
  • 276/277 - Claims Status Inquiry and Response - Providers may check individual claim status through UCare’s Provider Portal.
  • 999 - Implementation Acknowledgement - Providers who are enrolled with Availity or whose clearinghouse is enrolled with Availity are receiving transactions.
  • 270/271 - Eligibility Benefit Inquiry and Response - Providers may check individual member eligibility through UCare’s Provider Portal.
  • 835 - Electronic Remittance Advice - Providers who are enrolled with Availity or whose clearinghouse is enrolled with Availity will have the option to receive 835s. 

UCare is in contact with Change Healthcare. At this time, Change Healthcare has not shared timelines when services will be restored for payers. We will update this page as we learn more.

Pharmacy

A small number of members are reporting the inability to receive their prescriptions when presenting to their pharmacy. Change Healthcare is commonly used as one of the national pharmacy switch providers by many network pharmacies for claims and payment processing. Some of our network pharmacies rely solely on Change Healthcare as a pharmacy switch and as a result may be unable to send UCare/Navitus pharmacy claims at this time. This could result in some members being unable to receive their prescriptions. Impacted pharmacies are managing urgent or medically necessary prescription needs through emergency fill processes.

Prior authorizations

The outage is not affecting UCare’s prior authorizations. Providers should follow our usual processes for submitting prior authorizations. See the UCare Provider Manual for additional information.

Hospital admission notification

The outage is not affecting UCare’s hospital admission notifications. Providers should follow our usual processes for notifying UCare about hospital admissions. See the UCare Provider Manual (Hospital services chapter) for additional information.

Claim submissions

Providers may submit claims in the following ways:

  •  UCare is now able to accept claim submissions from Availity.
    • Providers can enroll directly with Availity or a provider's clearinghouse can enroll with Availity.
    • For providers needing emergency assistance, connection to all payers via Availity Essentials will be offered at no cost for the time being. Click here to learn more. We will share information as we learn more.
  • At this time, claims submitted through MN E-Connect are not affected by the outage. Providers may sign up with MN E-Connect (UCare Payer ID: 55413) to submit claims. On the MN E-Connect/Health EC application, a provider should only indicate UCare in the Payer Name (Insurance company name) section for the request form to receive access to the free Direct Data Entry (DDE) version (Individual Claim Submission).
    • Costs may be associated if using the application for other payers.
    • Additional charges may be incurred if indicating "yes" for additional services: Eligibility Services (Request/Response), 836 Batch Claims Submissions, ERA (Electronic Remittance Advice) or Claim Attachments.
  • For claims that are affected by this outage, UCare will extend timely filing by 30 days. UCare will reprocess claims with receipt dates of Feb. 28, 2024, to April 12, 2024, that have denied for timely filing in situations where the number of days past the timely filing deadline does not exceed 30 days. UCare will update this page when these claims have all been reprocessed. If you feel you have a claim that meets these criteria but did not get reprocessed, please contact us using a Reconsideration Form, and we will review.

Claim payments

On March 29, 2024, UCare began mailing paper checks for payment dates Feb. 23 and forward to those providers who are set up to receive paper payment. Currently, UCare is unable to bundle both the paper check and the explanation of payment (EOP) in a single envelope. EOPs are being sent separately.

Due to system limitations, providers receiving a paper check dated Feb. 23 to March 27 may receive a duplicate 835.

At this time, electronic payments are not affected by the outage. Providers are encouraged to sign up for electronic funds transfer (EFT)/electronic remittance advice (ERA). This can be done on the new portal - select the “Provider Payment and Remittance Request Form” located under the “Resources” tab in the “Resource Center.” 

Remittances

Providers who were enrolled with Availity or whose clearinghouse was enrolled with Availity by March 14, 2024, received 835s for payment dates Feb. 23 and forward. Providers who enroll after March 14, 2024, will receive current 835s within a week of enrollment. For the time being, UCare is not requiring providers to populate an Electronic Remittance Advice form on the UCare Provider Portal once enrolled with Availity.

On March 18, 2024, UCare began temporarily mailing paper EOPs for payment dates Feb. 23 and forward that are 50 pages or less to get remittances to the majority of providers. At this time, UCare is unable to bundle both the paper check and the EOP in a single envelope. EOPs are being sent separately from the paper check and may arrive first.

All EOPs are being sent via paper regardless of whether a provider is enrolled to receive electronic remits. This may result in some providers receiving duplicate remit information. Additionally, at this time, EOPs are not accessible on UCare's Provider Portal.

Due to system issues at the clearinghouse level, UCare received duplicate claim files on two separate occasions between March 23 and April 10. Providers may experience a higher incidence of duplicate claim denials on remits (835s and EOPs).

Helpful tips for providers

UCare has collected the following tips to assist providers during the outage:

  • Individual member information - available on the Provider Portal or by contacting the Provider Assistance Center.
  • Viewing check payments, which may help you validate payment to members - On the new portal, from the dashboard, click “View Claims” and then search by check number. To see additional details per claim, click on the Claim Number hyperlink. Screenshots are available on page 37 of the Provider portal user guide.