A new eClaims interface has been provided by Optum, Change Healthcare’s parent company. Optum was not affected by the cyber attack, so this interface was not involved. You can find more information here.

The Sycle team tested the interface and started processing claims on March 19, 2024. Since this is a rapidly changing situation, our testing continues. Also, since this is a new interface, new requirements have been emerging that need to be added to your processes.

Here is the current list of important steps that you need to take. We will continue to update this list as we uncover new needs and recommend that you periodically check that latest information.

  • Review the HCFA Status report to determine the current status of your claims (Reports > HCFA Status)
  • Expect delayed updates to statuses on the HCFA Status Report
  • New eClaim submissions will be grouped and submitted periodically to monitor performance
  • Claims statuses will remain “Submitted” until Sycle is able to submit the next batch of queued claims to iEDI. It may then take several days to receive the status update, including any possible rejections.
  • Rejection reasons can be viewed, once available, by clicking the date hyperlink in the “Created” column to open the HCFA Form and reviewing the messaging section
  • For claims submitted multiple times, Optum indicated the payer will only process one claim (for example – if both a paper claim and an eClaim were submitted)
  • iEDI only recognizes numeric values in the Federal Tax ID field. Sycle has proactively updated this field by removing all hyphens currently configured. Sycle will correct this error so ignore it.
  • “H H25387 The ‘Billing Provider Tax Identification Number’ does not match the format of a Tax ID Number.”
  • There is a new approved payer list for the Optum iEDI interface that is different from the Change Healthcare list here. Optum has indicated they will continue to add more payers for timely processing.
  • Explanation of Benefits (EOBs). Optum’s iEDI does not support electronic EOBs with the current interface. Please reach out to the payer(s) to request EOBs be sent directly to your practice or check if they can provide direct access through a payer portal.

 

Also, here is a reminder about resources available to you:

We hope this information helps. If you have questions, please email or call our Customer Experience team at support@sycle.net or 888-881-7925.

April 12, 2024 - Update Regarding Medicare Remittance

In response to Medicare claim submission issues you may have been experiencing as a result of the Change Healthcare cyberattack, Optum worked closely with CMS and Medicare Administrators to reenable claim submission through an aligned approach.

We have continued to expand our alignment with Medicare Administrators to support accelerated access to electronic remittance advice (ERA) transactions from the Change Healthcare/Relay Exchange clearinghouse platforms to the Optum Intelligent EDI Platform (iEDI).

Each Medicare Administrator is actively working with Optum to support the delivery of previously generated ERA transactions and future ERA transactions to iEDI enabled through options including granting iEDI access to previous CHC mailboxes, alignment to new receiver IDs, etc. 

As the Change Healthcare/Relay Exchange clearinghouse platforms come online, iEDI is establishing provider linkage to reinitiate ERA processing for Medicare Administrators without requiring reenrollment by the submitting providers.

Any providers that have already initiated enrollment to gain access through another clearinghouse connection will not be included in this move or will be migrated off iEDI to their new clearinghouse once that enrollment is processed by the Medicare Administrator.

Over the next week, iEDI will be announcing the addition of ERA availability across Medicare Administrators with information that highlights auto delivery of electronic remittance and paper remittance processes.

“In response to Medicare claim submission issues you may be experiencing as a result of the Change Healthcare cyberattack, Optum has been working closely with CMS and Medicare Administrators to enable claim submission while ensuring future connectivity as the Change Healthcare claim processing solutions are restored.

Medicare administrators will be supporting bulk dual enrollment for providers that were enrolled and submitting claims through the Change Healthcare/Relay Exchange claim processing platforms to the Optum Intelligent EDI Platform (iEDI).

This dual enrollment approach will enable providers to utilize their current submission methods actively in place or in the process of being restored to send claims through iEDI. Optum will also notify clearinghouses and vendors that they can resume claim submission through their existing Optum connectivity channels for Medicare claim delivery to the appropriate Medicare Administrators.

Each Medicare Administrator is working with Optum to ensure that we are aligning providers appropriately to their systems for a bulk enrollment to iEDI. As each Medicare bulk copy is completed and claim submission becomes available, we will provide updates via our Optum provider communication portal, clearinghouse announcements and vendor outreach channels. Medicare Administrators will also communicate updates on their websites. Providers that have already processed an enrollment to move away from the Change Healthcare clearinghouse connection will not be dual enrolled.

Any providers with an enrollment that is in process through standard paper submission will be migrated off the dual enrollment connection to their new clearinghouse once that enrollment is processed by the Medicare Administrator.”

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