On Feb. 21, 2024, Change Healthcare announced they experienced a cybersecurity incident. We are not aware of any impact to our systems. However, the implications of Change Healthcare’s incident touch many of our health care partners.
Options for Submitting Claims
March 1, 2024
As a provider, you have options for submitting claims that don’t require connectivity with Change Healthcare. Those include:
- Signing in directly to the Availity® Essentials portal to conduct transactions including eligibility and benefits verification, prior authorization requests, claim submissions and to check claim status.
- Using an alternate clearinghouse to submit your claims via Availity.
Sending claims electronically is preferred and is your fastest path to payment.
Availity: If you aren’t familiar with Availity, there are several resources to help. Availity is offering a lifeline to providers who have not previously used Availity.
More information: Our Claims and Eligibility page has information about submitting claims. Our Eligibility and Benefits page has information about options for checking members’ benefits. Availity has provided updated information and options for providers on its website. You may also call our provider helpline at (800) 835-8699.
Important Notice Regarding the Change Healthcare Incident and NM OSI Order
Updated April 18, 2024
Effective March 20, 2024, the New Mexico Superintendent of Insurance issued an order in response to the Change Healthcare cybersecurity incident. The order applies to fully insured major medical plans regulated by the OSI. It remains in effect through May 19, 2024.
The OSI found that the cybersecurity incident created challenges in accessing health care due to its impact on claims submission and payment, eligibility and benefits verification, prior authorization requests, and prescription fulfillment. To protect small, independent providers, the order contains directives to insurers such as Blue Cross and Blue Shield of New Mexico.
Contents of the order: The order directs insurers to make accommodations for New Mexico health care providers who are impacted by the Change Healthcare incident and not affiliated with a hospital. These accommodations are:
- Temporarily suspending prior authorization requirements
- Temporarily suspending claim denials for lack of utilization management approval, prior authorization or eligibility confirmation
Impacted providers: Shortly after the Change Healthcare incident, we identified and reached out to providers impacted by the incident. For impacted non-hospital affiliated New Mexico providers that we contacted, we’re suspending prior authorization requirements and will not retroactively deny claims for the reasons listed above.
If we did not contact you and you believe your practice is a non-hospital affiliated New Mexico provider impacted by the Change Healthcare cybersecurity incident, please call our provider helpline at 800-835-8699 or your network representative.
Timely filing: For New Mexico healthcare providers not affiliated with a hospital, the order further directs insurers to temporarily waive timely filing requirements for claims and appeals for New Mexico fully insured business.
More information: View the order on the OSI website.