Change Healthcare Outage

Announcement 10/28/24

As we previously shared, Elderplan has recently partnered with Zelis Healthcare, LLC, a provider of business services to its clients in the health care industry, to offer a new electronic claims payment processing system. We are excited about this new partnership and believe it will improve the processing/payment of our claims.

Details on Electronic Funds Transfer (EFT)

Beginning on October 28, 2024, providers can register for EFT payments. Our partner for EFT and paper check payments is Zelis.

• If you are already enrolled in Zelis Payment Network, no action is needed. Zelis will transfer electronic payments to you for Elderplan claims as soon as possible using your existing payment preferences.
• If you are not currently enrolled with Zelis, you will be able to register to receive EFT payments at no cost to you through the Elderplan ePayment Center. To register, please visit elderplan.epayment.center.
• If you are not sure about your enrollment status, please contact Zelis at 1-877-828-8770.
• Electronic payments will begin soon after registration. In the meantime, any claims payment available to you will be sent via paper check from Zelis to the address on file.
• If you file electronic claims, 835 files will be available via Zelis, iEDI, and TransShuttle. Zelis sends paper check payments with printed claim backup detail.

Reminder for capitated providers

Providers who receive PMPM capitation for medical services will continue to receive payments in the mail from Change Healthcare.  EFT is not yet available for capitated providers.

Announcement 10/2/24

ELDERPLAN IS PROUD TO ANNOUNCE A NEW PAYMENT VENDOR

Elderplan is pleased to announce a new partnership with Zelis Healthcare, LLC, a provider of business services to its clients in the health care industry, which will allow Elderplan to offer a new electronic claims payment processing system. We are excited about this partnership and believe it will improve our claims payment processing services.

Details on the New Check Payment System WITH Explanations of Payment (EOPs):

• Effective October 7, 2024, all claims payments issued to providers will be sent by Zelis via paper check, accompanied by a corresponding EOP. The check and EOP will be sent to the billing address we have on file for you.
• For all payments that Elderplan has made via paper check since the Change Healthcare outage in February 2024, Zelis will begin mailing corresponding EOPs. Electronic copies of the EOPs for payments issued between February and September will also be available within the Elderplan Provider Portal.
• Additionally, providers can still continue to pull 835 files via TransShuttle and iEDI.

We will be sending out instructions within the next few weeks on how to register with Zelis for EFT reimbursement. Elderplan will notify you when registration is open.

If you are already enrolled in the Zelis Payment Network, no action is needed. Zelis will transfer electronic payments to you for Elderplan claims as soon as possible, using your existing payment preferences.

Update for capitated providers

Effective September 1, 2024, providers who receive PMPM capitation for medical services began to receive payments in the mail directly from Change Healthcare. This was a return to the process that was in place prior to the Change Healthcare outage. The payments from Change will include backup data for each check and, therefore, Elderplan will no longer send a separate capitation file.

Reminder for Claims Submission

For submission of claims, providers should continue to utilize one of the below options:

1. Optum iEDI
2. TransShuttle
3. HHA Exchange
4. Paper claims

Elderplan remains committed to supporting our provider community. Should you have any questions, or require additional support, please reach out to Provider Services by calling 1-800-353-3765 and selecting Option 2.

Update 4/29/24

Elderplan is committed to our provider community and supporting you during the Change Healthcare outage. Please reach out to Provider Services if you have any questions by calling 1-800-353-3765, option 2.

Update on Claims Submission

Elderplan now has the ability to receive daily claims via Optum iEDI.  If a provider submitted a claim to Elderplan via Change Healthcare or Optum at any time, including before, during, or after the cybersecurity outage, it has been sent to the Elderplan claims system and been processed.

If a provider submitted a claim via Optum and then, due to the outage, submitted the same claim via another platform, Elderplan’s system will not process the duplicate claim.

If a provider now wants to begin submitting claims via Optum iEDI, the Elderplan Payer ID is 31625.

These are the submission options that are available for sending claims to Elderplan.  Each of the following services is free for providers to use.

1. Optum iEDI
2. TransShuttle*
3. HHA Exchange
4. Paper claims

*Many providers are submitting claims through other clearinghouses, such as Availity, All Data Service, Cortex EDI, Claim.MD, or Electrobills. TransShuttle has the ability to work with those clearinghouses, but a connection must be established between the clearinghouse and TransShuttle in order for claims to be transmitted via TransShuttle to Elderplan for processing.  Please contact your clearinghouse and arrange for them to transmit your Elderplan claims to TransShuttle. Otherwise, Elderplan will not receive the claims.

Update on 835s/Explanations of Payment (EOPs)

Elderplan can produce 835 files with claim backup data for providers who submit claims via Optum iEDI, HHA Exchange, or TransShuttle.

Providers who submit via TransShuttle can see the 835 files on the TransShuttle dashboard.  You can view and download the files.

Providers who submit via Optum iEDI or HHA Exchange should continue doing so, but must register with TransShuttle to view and download the 835s.  To access the guide containing registration instructions, simply click here. For assistance with navigating the system, click this link.

835s are available for all claims submitted via Optum, HHA Exchange, or TransShuttle since the beginning of the Change Healthcare outage. 835s are not available directly from Optum or HHA Exchange at this time.

Update on issuance of paper checks

Elderplan is producing and mailing paper checks for claims payment on a weekly basis. EFT is not available at this time due to the Change Healthcare outage. Elderplan continues to work on an alternate EFT solution.

Update 4/5/24

Elderplan is committed to our provider community and supporting you during the Change Healthcare outage. Please reach out to Provider Services if you have any questions by calling 1-800-353-3765, option 2.

Can Elderplan produce Explanations of Payment (EOPs)?

Elderplan is very pleased to share that we can now produce 835 files with claim backup data for providers who submit claims via HHA Exchange or TransShuttle.

Providers who submit via TransShuttle should be able to see the 835 files on the TransShuttle dashboard.  You can view and download the files.

Providers who submit via HHA Exchange should continue doing so. In addition, these providers need to register with TransShuttle to view and download the 835s.  To access the guide containing registration instructions, simply click here. For assistance with navigating the system, click this link.

835s are available for all claims submitted via HHA Exchange or TransShuttle since the beginning of the Change Healthcare outage.

Claims Submission

Elderplan can continue to receive claims from providers* while the Change Healthcare platform remains inaccessible. Please refer to the three options below, and choose the option that best fits your needs. Each service is free for providers to use.

1. HHA Exchange
2. TransShuttle
3. Paper claims

*Many providers are submitting claims through other clearinghouses, such as Availity, All Data, Inovalon, Claim.MD, or Electrobills. TransShuttle has the ability to work with those clearinghouses, but a connection must be established between the clearinghouse and TransShuttle in order for claims to be transmitted via TransShuttle to Elderplan for processing.  Please contact your clearinghouse and arrange for them to transmit your Elderplan claims to TransShuttle. Otherwise, Elderplan will not receive the claims.

Update on issuance of paper checks

Checks in payment of claims received by March 15 were sent out on April 2.  If a provider does not receive a check by May 10, they can reach out to [email protected].