Change Healthcare Outage

As we continue to work through the Change Healthcare outage, we would like to offer an update and additional guidance.

What are the known issues related to submitting claims to the restored Change Healthcare Clearinghouse? UPDATED 6/5

1. Change Healthcare is aware of an ERA issue with Cigna and are addressing it. We will provide updates as we learn more.

2. Change Healthcare is aware of an Eligibility issue with Aetna. If you are experiencing issues with Eligibility or differences in results since the Change Healthcare incident, outside of the known Aetna issue, please submit an online support case.

What is the status of the Payors that were suspended on or around April 11? NEW 4/29
On or around April 11, Change Healthcare removed a limited number of payors from the published list of connected payors after identifying unexpected connection issues. Change Healthcare has continued to restore these connections overtime.

We published the list of suspended Payers, including the date of suspension and restoration. The list can be accessed from the Change Healthcare Suspended Payers List help file (see the Change Healthcare Outage/Availity folder in the Table of Contents). This list is updated approximately twice a week, or as updates are received. If you experience issues with a specific payor please review this list prior to reaching out to support. Change Healthcare is actively working to restore connections to each of the listed payors.

The most up-to-date list of active Change Healthcare payers is available from the published list of connected payors.

What is the status of ERAs? UPDATED 4/23
Change Healthcare has added payor ERA status to the published list of connected payors. ERA files for payors from Change Healthcare started to come into our practice management at approximately 12 p.m. MT on Thursday, March 28. ERA coverage is not 100 percent yet and will increase over time. We are receiving a small subset of backlog ERA files from payors with payment dates for February 21 and forward. Depending on the payor you may or may not receive backlog ERAs.

Will AdvancedMD re-bill claims on my behalf? NEW 4/10

AdvancedMD will not be able to automatically re-bill claims on your behalf. Please see the Release Guide from April 4, which can be accessed in Hub or directly from the Dashboard News in the practice management software. If you are an AdvancedMD RCM client, your RCM specialists will manage this process on your behalf.

Why am I receiving the rejection message “Due to the recent cybersecurity incident, there is not currently an electronic path available for this payer. Please look for alternative routes for claim submission until further notice”? NEW 4/5

When Change Healthcare confirmed restoration, we submitted all claims with a submitter type of Mckesson to Change Healthcare. Some payors were reconnected, and others were not. If you receive this rejection review the claim in question and verify the reconnection date for the payor listed on the published list of connected payors. If the claim submission date was prior to the approved date, re-bill the claim. If the claim was submitted after the approval date, please submit an online case with a visit example.

Change Healthcare is reviewing unexpected rejections for claims submitted to CPID’s 4237, 3230, 3883, and 8817 after the approval date.

Can you provide a timeline for when a specific payor will be reconnected to Change Healthcare? NEW 4/3

No, Change Healthcare is not able to provide payor specific restoration estimate. Additional payors continue to reconnect to the restored Change Healthcare clearinghouse. For ongoing payor connectivity updates and the most up to date payor list, please visit and bookmark the published list of connected payors. This payor list is updated every weekday evening.

Do we need to re-enroll payors with Change (Claims and ERAs)? NEW 4/2

At this time there is no need to re-enroll with payors who require agreements through Change Healthcare. As payors reconnect to Change Healthcare, previously established claim and ERA agreements will be honored. In the unlikely event a payor is unwilling to honor an existing agreement, we will contact impacted clients to begin re-enrollment. However, if you enrolled with a different clearinghouse during the outage, you must re-enroll with Change Healthcare once the payor has reconnected to the Change Healthcare clearinghouse.

Will my rejections and exclusions for claims submitted to Change Healthcare flow into AdvancedMD? UPDATED 4/3
Yes. Now that the Change Healthcare clearinghouse is restored, claims processed through Change Healthcare for reconnected payors will flow into our practice management just as they did prior to the outage. For ongoing payor connectivity updates and the most up to date payor list, please visit and bookmark the published list of connected payors. This payor list is updated every weekday evening.

When should we transition from sending claims to Availity back to Change Healthcare? NEW 3/29
The Change Healthcare integration offers a more streamlined workflow compared to Availity. We recommend changing your carriers back to the Change Healthcare (McKesson) clearinghouse as they become available.

What options are available to process government claims? UPDATED 4/2

Options available now:

• Process claims electronically with the restored Change Healthcare clearinghouse for Medicare and Medicaid payors that have reconnected.
• Print claims in your office and mail to payors accepting this method. Medicare has shared it is prepared to accept paper claims as an alternative submission method. See our Claims Submission Wizard help file for instructions on how to drop your claims to paper. Change Healthcare paper claim submission has also been restored.
• Keying claims into provider portals in addition to entering charges in AdvancedMD, if necessary, to prevent additional cashflow disruptions.
• Process claims manually using the 837 download (5010D). NOTE: We do not recommend this option, due to downstream reconciliation challenges, and differences in the 5010D header that makes it difficult for other clearinghouses to accept. This option is available by request only.

How will we process backlog claims that fail to run through Availity? UPDATED 3/29
If the payor is available at Change Healthcare, you can update the submitter to Change Healthcare (McKesson) and re-bill the claim. For tools to assist in updating submitters and to re-bill claims in mass, please review our Carrier Update Tool and Mass Re-bill Claim help files. If the payor is not available through Change Healthcare yet, you can re-bill the claim through Availity.

How do I get a copy of my ERA to use with the new ERA import tool? NEW 3/28
You will begin to receive ERA files for a very limited group of payors from Change Healthcare as of Thursday, March 28, 2024. We anticipate ERA files from additional payors as they come back online through Change Healthcare. To prevent frustration, please do not contact support for additional information. Additional details will be shared as we learn more. For payors you have not received an ERA for, you will need to continue to contact payors directly for alternative options. Some payors offer “payor portals” in which you can enroll to download 835 ERA files online and import into AdvancedMD. Please see the release guide for more information.

Which tools were made available to help mitigate the Change Healthcare outage? NEW 3/27
On Friday, March 22, we released five new features to help mitigate the outage. Please see the release guide within the product for details on how to leverage these new capabilities.

1. Availity submitter
2. Availity claim EDI reports
3. AdvancedMD ERA import tool
4. Carrier update tool (Updated the evening of 3/27 with institution billing support)
5. Mass re-bill claims by NPID

Which file formats does the new AdvancedMD ERA import tool accept? UPDATED 3/26
The ERA (835) import tool will accept .txt, .DAP, .EDI, .xml, .docx, .doc, and .png file formats.

ISA header refers to the Interchange Control Header segment. The ERA (electronic remittance advice) file is a standardized electronic file format for transmitting payment and remittance information from payors to providers. The ISA header is the initial segment of the file. The ISA header includes information such as sender and receiver identification, date and time of transmission, control numbers, and the interchange control version number. It helps ensure the integrity and security of the electronic data interchange (EDI) transaction by providing necessary routing and identification details.

As an example: If you have login access to UnitedHealthcare or Zelis, you can download the raw 835 file and import it using the ERA import tool. Similar capabilities are available from other payor portals.

How do I get support for my Availity claim reports? NEW 3/22
Please do not call the support desk for assistance related to Availity claim reports. The fastest method to get support is to submit an online support case. We have additional resources, who have received specific training, to help respond to online support cases related to Availity claim reports. Online support cases will be the fastest method of support for these types of questions.

What should we do if we identify an incorrect NPID? NEW 3/21
To report an NPID mapping issue, submit an online support case. This will help our teams maintain an accurate list for our Help Files/Hub articles. You should then determine the correct NPID by reaching out to the payor or reviewing an available patient insurance card and correcting the NPID in your office key. Finally, you can re-bill the claim with the corrected payor information.

Our team performed the initial mapping exercise from Change Healthcare payor IDs (CPIDs) to Availity payor IDs (NPIDs) to facilitate a quick transition. We will not modify these mappings, nor any other carrier settings, going forward. Like CPIDs, it is your responsibility to update and maintain carrier information.

Should I enroll directly with Availity? UPDATED 4/2
We do not recommend enrolling directly with Availity. We are working on your behalf to reestablish claim submissions for government payors (Medicare and Medicaid) and payors that require agreements. Direct enrollment with Availity will disconnect established agreements with Change Healthcare, and you must re-enroll with Change Healthcare once the payor is restored in the clearinghouse.

Are carriers accepting paper submissions? UPDATED 3/25
Please reach out to your carriers for information regarding paper claims. Medicare has shared their readiness to accept paper claims as an alternative submission method. Contact Medicare directly for requirements of paper claim submission. We are currently testing this ability and will provide more details soon.

Which payors are supported by Availity? UPDATED 3/20
For the most accurate list of our payer connections with Availity, please reference our Help Files.

Will my clinic need to map Change Healthcare payors to Availity payors? UPDATED 3/20
Our team performed the initial mapping exercise from Change Healthcare payor IDs (CPIDs) to Availity payor IDs (NPIDs) to facilitate a quick transition. We will not modify these mappings, nor any other carrier settings, going forward. Like CPIDs, it is the client’s responsibility to update and maintain their carrier information. We are aware of a couple NPID corrections that need to be made, targeted in-app alerts will be used to inform our users to review and update those payors. We added the NPIDs to the best of our ability when adding the NPID fields into the product so each client would not need to go in and manually populate those fields from scratch.

How will we know the status of backlog claims run through Availity? UPDATED 3/22
Availity reports for claims acceptance, rejections, exclusions, and denials are available in our practice management. Please see the release guide for more details. Failed claims will NOT populate in the exclusions worklist initially.

When will ERAs start to drop into my office key? UPDATED 4/5
Change Healthcare has added payor ERA status to the published list of connected payors. You will begin to receive ERA files for a very limited group of payors from Change Healthcare as of Thursday, March 28. We anticipate ERA files from additional payors as they come back online through Change Healthcare. We are receiving a small subset of backlog ERA files from payors with payment dates of Feb. 21 and forward. Depending on the carrier, we may or may not, receive backlog ERAs. More details will be shared once known. This update is fluid and we do not have specific information on which payors you will see ERA files for right now. To prevent frustration, please do not contact support for additional information. Additional details will be shared as we learn more.

Will AdvancedMD support another clearinghouse? UPDATED 3/15
We will support Availity as an additional clearinghouse during the outage. Once services are restored, we will continue our work to select and integrate an additional clearinghouse to provide the best claims experience possible for our clients.

Will I be charged for re-bills necessary due to the Change Healthcare outage?
No. To support you through this outage, we will not charge for re-bills sent through Availity.

Why did you choose Availity as an alternate clearinghouse?
AdvancedMD has an existing relationship with Availity, and this was the fastest and most viable path to resume claims processing.

What will happen to the backlog claims that were set to CPID 4320? (CPID 4320 indicates that the claim should be dropped to paper and mailed by the clearinghouse.) UPDATED 3/29
Dropping claims to paper has been restored at Change Healthcare.

Do I need to sign up for the Availity paid plan to process claims?
You do not need to sign up for a separate Availity paid plan.

Does Availity utilize CPID codes or another form of electronic payor ID?
Availity uses National Payor IDs. We’ve mapped these for our clients and this data will be added to your Office Key in a future update.

Should we process claims manually using the 837 download (5010D) option?
We do not recommend this option currently, due to downstream reconciliation challenges, and differences in the 5010D header that make it difficult for other clearinghouses to accept. This is an option, upon request, but we do not recommend choosing this approach lightly.

Can AdvancedMD help me with manually updating my 837 download (5010D) files?
No, the AdvancedMD team is working to integrate additional clearinghouses to support claims processing in bulk, which should be the most efficient path for the majority of our clients. We are unable to support manual adjustments to individual 5010Ds.

Should I stop running my end-of-day process?
No, we recommend continuing to run your end-of-day process. We will process queued claims as soon as feasible.

What will happen with my ERAs once claims are submitted through Availity? UPDATED 4/5
You will begin to receive ERA files for a very limited group of payers from Change Healthcare on Thursday, March 28, 2024. We anticipate more ERA files will be received as additional payors come back online through Change Healthcare. This update is fluid. We do not have specific information on which payors you will receive ERA files from right now. To prevent frustration, please do not contact support for additional information. Additional details will be shared as we learn more. ERAs will be sent to Change Healthcare once services are restored or until enrollments are changed. Some payors have temporarily discontinued sending ERAs to Change Healthcare and are instead sending physical copies. Change Healthcare has added payor ERA status to the published list of connected payors.

With the extended outage for government electronic claims submission, what can we do? NEW 3/19
As we continue to make progress to restore electronic claims submission for government payors, and all payors that require enrollments, we encourage you to take advantage of the Change Healthcare\Optum Payment Disruption (CHOPD) program. We have heard that several clients are receiving meaningful support through this program.

What is the recommendation to mitigate cashflow interruptions in the interim? UPDATED 3/11
Due to the delay in claims processing, some of our clients have found success with the following options:

• CMS Announces Change\Optum Payment Disruption (CHOPD) program
• Optum Pay (see below)
• Short-term business bank loan
• Aquina/Via – Instant Claims Payments & RCM Tool

What can Optum Pay do for my practice?
Optum Pay is a solution Change Healthcare is offering, through Optum Financial, to provide loans based on historical cash flow processed through Echo Health. Echo Health is a payment processor for a limited group of payors to handle EFT payments. With Echo Health overseeing a limited group of payors, reimbursements will vary dependent on volume of transactions processed through ECHO Health. To determine eligibility and funding amount, you must register for the program. An Optum Pay account is required to complete registration and to receive funds. Use your existing Optum Pay account or sign up for Optum Pay to log in. For the most up-to-date information please visit UnitedHealth Group’s FAQs.

Will we lose the ability to leverage Optum Pay if we start processing claims outside of Change Healthcare? 
No, Optum Pay will still be available for clients that identify alternate means to process claims.

What does the CMS accelerated / advance payment option do for my practice? UPDATED 3/11
CMS made the following announcement “On March 9, 2024, CMS made available Change Healthcare/Optum Payment Disruption (CHOPD) accelerated payments to Part A providers and advance payments to Part B suppliers experiencing claims disruptions as a result of the Incident.” Providers must contact their Medicare MAC directly with questions on requirements to receive accelerated or advance payments.

What is the status of the Claim Attachment function? UPDATED 6/24
Change Healthcare started integrated testing of the Claim Attachment function during the week of June 24. We anticipate full-service restoration for a very limited set of carriers in the coming weeks.

What is the status of Change Healthcare’s Enrollment Central Tool? NEW 5/7
Change Healthcare’s Enrollment Central tool, which is what we use to create EDI agreements, remains unavailable and currently an estimated restoration date has not been provided. We worked with Change Healthcare to develop a temporary, manual process to create agreements for payors that are on the published list of connected payers. If a payor is not on this list, agreements cannot be created.

Why is my Payor telling me that they are not connected to Change Healthcare when they are on the Change Healthcare published list of connected payors? NEW 4/17
Change Healthcare reestablished connections to payors through both direct connections and intermediaries. If a payor is reporting they are not connected to Change Healthcare but are listed on the published list of connected payors, they are likely reconnected via an intermediary. The connection method does not impact the services available through Change Healthcare.

What is the status of the claim status function? UPDATED 5/7
Change Healthcare’s Claims Status function was restored Tuesday, May 7 for a limited group of payors. For ongoing payer connectivity updates, please visit and bookmark Change Healthcare’s Exchange Payer List.

What is the status of insurance eligibility? UPDATED 4/17
Insurance eligibility services have been restored. You can check Exchange Real-Time for a limited group of payors from Change Healthcare. See the exchange real-time payer list for the most current list of payors.

AdvancedMD support does not have specific information about when or which additional payers will be restored. Monitoring payors in the exchange real-time payer list is the best way to manage the process.

If you check real-time eligibility for a payor not located on the Change Healthcare exchange real-time payer list, you will receive the following response: “Rejected at Carrier level: UNABLE TO RESPOND AT CURRENT TIME. Follow up: PLEASE RESUBMIT ORIGINAL TRANSACTION.” Please do not resubmit another Eligibility check until you have validated this payor has reinstated Eligibility connections.

What is the status of Relay Exchange’s ability to print claims on our behalf? NEW 4/16
The connection to Relay Exchange’s third-party printer is online. If you need to send paper claims through Relay Exchange, it is important that you ensure you have the correct CPID entered for relevant carriers. Claims submitted using a CPID designated for paper will now be printed and mailed by the clearinghouse.

More details and the list of carrier paper CPIDs can be accessed from the Change Healthcare CPIDs for Paper Claim help file in AdvancedMD (see the Change Healthcare Outage/Availity folder in the Table of Contents).

What is the status of the Change Healthcare clearinghouse? UPDATED 4/3
The connection to the Change Healthcare clearinghouse came online for all clients at approximately 3:30 p.m. MDT on Thursday, March 28. Not all payors will be available when services are initially restored. Change Healthcare is adding more payors daily and is updating the published list of connected payors every weekday evening.

We received assurance letters from UnitedHealth Group, Bishop Fox, and Mandiant that provide adequate evidence the Relay Exchange Clearinghouse is safe for restoration of services, a necessary step for us to restore our integration.

On Wednesday, February 21, AdvancedMD was made aware that Change Healthcare (a subsidiary of Optum), experienced a cybersecurity event (cyberattack). As of the posting of this FAQ, Change Healthcare has confirmed its Medical Network and Medical Network API systems are unavailable.

Was any patient data (PHI) exposed in the attack? UPDATED 4/24
On April 22, 2024, UnitedHealth Group published a press release providing an update on their review of impacted patient data and announcing a new website (changecybersupport.com) “for people who are concerned about their personal data due to the criminal cyberattack on Change Healthcare systems”. The site provides a toll-free telephone number for a dedicated call center offering free credit monitoring and identity theft protections for two years to anyone impacted by the security incident. Emotional support services are also available from trained clinicians.

The site also provides updated information about the analysis being performed by UnitedHealth Group security teams and security vendors, as well as other details about the attack and privacy of PHI and PII as it becomes available. This update is fluid and we do not have specific information on impacted patient data. To prevent frustration, please do not contact support for additional information. Ongoing updates will be posted on the Change Healthcare website (changecybersupport.com).

Is Change Healthcare facing a second ransomware request? NEW 4/9
We do not have any information supporting reports that Change Healthcare received a second ransomware request. However, it is important to note that there was not a second cybercrime attack. The reports are related to a ransom demand from a second group related to the single attack reported on February 21. All the information UnitedHealth Group has made available can be found on its FAQ page, under “Is patient health information compromised?” When change Healthcare restored services, a completely new infrastructure was created. We received assurance letters from UnitedHealth Group, Bishop Fox, and Mandiant that provide adequate evidence the Relay Exchange Clearinghouse is safe for restoration of services, a necessary step for us to restore our integration. Change Healthcare is still working through the forensic analysis of the incident. We will be notified as soon as the forensic analysis is complete.

When did the security incident happen?
Change Healthcare identified the attack very early on Wednesday, February 21, and shut down systems at about 5am EST.

What type of cyberattack took place?
Change Healthcare has reported to partners and the media that they experienced a sophisticated cyberattack that is consistent with state-sponsored cyberterrorism. The ransomware that caused the incident has been reported by news media as ALPHV BlackCat.

What Change Healthcare systems were impacted by the cyberattack?
Change Healthcare indicated the attack directly impacted its “internal systems.” We’re told the production systems were not directly impacted, but connections were shut down out of an abundance of caution because they are “adjacent” to the impacted systems, meaning that there is a possibility of lateral movement of the attack.

Where is the best place to stay informed?
The AdvancedMD Incident Management team will continue to monitor the outage and resolution timing. We will continuously update the AdvancedMD Status Page, this FAQ page, and software alerts to keep you informed with the latest information.

What is the relationship between Change Healthcare, UnitedHealth, and Optum?
UnitedHealth Group and its subsidiary, Optum, acquired Change Healthcare when it was a separate company in a deal that was closed in 2022. Change Healthcare is now part of Optum, the health services division of Minnesota-based UnitedHealth.

Change Healthcare is owned by Optum, which is a subsidiary of UnitedHealth Group. Were any Optum or UnitedHealth systems impacted?
From the Change Healthcare status page: “We have a high-level of confidence that Optum, UnitedHealthcare and UnitedHealth Group systems have not been affected by this issue.” Source: Optum Solutions Status – Update: Some applications are experiencing connectivity issues.

What is Change Healthcare doing to remediate this incident?
UnitedHealth Group has assembled “three of the best security forensics companies in the world” to help its internal experts diagnose the issue, determine scope of the impact, remediate the incident, and provide an impact report to customers, including AdvancedMD. UnitedHealth has assured us that it has all available resources working 24 hours a day (in two 12-hour shifts) until remediation is complete.

Is there any risk to AdvancedMD servers and databases?
There is no reason to believe that AdvancedMD systems could have been impacted by this incident. There is no VPN or other continuous connection between AdvancedMD and Change Healthcare, and any data that is exchanged between the two platforms is pushed or pulled by AdvancedMD. Change Healthcare has no mechanism to push data into the AdvancedMD infrastructure. Also, Change Healthcare shut down all services as soon as the attack was identified, which minimized the interaction between AdvancedMD and Change Healthcare after the incident took place.

AdvancedMD has many security controls in place to prevent and detect security incidents. Our security team has found no indication of any impact in our systems from the cyberattack on Change Healthcare.

Does the Change Healthcare outage impact patient statements?
Electronic statements are not processed through Change Healthcare, so there is no interruption to this service. Paper statements are printed on paper within your office, so these aren’t impacted by the outage.

Is my data secure?
At this time there are no indications that the data of AdvancedMD customers in the possession of Change Healthcare has been compromised. However, the forensic analysis is still underway. As more information becomes available, we will continue to share updates.

The security of AdvancedMD servers and databases was not impacted by this incident.