Aetna reports in-network provider payment disruptions, due to Change Healthcare hack
Aetna uses Change Healthcare as an intermediary for certain data exchanges, and many of its in-network providers use it to submit claims to Aetna, however, the insurer announced its systems have not been comprised.
The impact of the recent cyberattack on Change Healthcare has now reached Aetna and some providers, who may not be paid on time.
“There is no indication that Aetna’s systems have been compromised,” the company said in a bulletin for providers and other stakeholders. “We’re committed to ensuring access to care as we navigate through this network disruption. We have business continuity plans in place to minimize disruption of service and apologize for any inconvenience our network providers and members may experience. We will continue to utilize our business continuity plans to minimize disruption until the Change Healthcare services are restored.”
Aetna uses Change Healthcare, a subsidiary of UnitedHealth Group’s Optum, as an intermediary for certain data exchanges, and many of its in-network providers use it to submit claims to Aetna, the insurer said in a message to providers.
“We are aware that some providers across our lines of business and affiliates may not be getting timely payments at this time, and we take this very seriously,” the company said. “At this time, we’re exploring contingency payment options, particularly for providers in our Medicaid plans who receive payment via paper check.”
The bulletin shared commercial, individual, family plan and Medicare submissions contingencies while the service interruption continues:
- EDI transactions: “We’ve been advising our network providers who directly use Change Healthcare for EDI transactions for Aetna to stay `digital first’ and use one of our other business partners for their electronic transactions until Change’s service interruption is resolved.”
- Provider portal: “Providers can also use our existing medical provider portal hosted by Availity or dental provider portal hosted by Dental Exchange for electronic claims submission.”
- Alternate e-transactions: “If providers work through a billing partner, practice management system or other vendor partner, they likely can advise on an alternate connection method for electronic transactions with Aetna.”
- Paper claims: “Finally, when digital submission isn’t possible, providers can also reach out to our Aetna provider contact centers about submitting paper claims.”
For Aetna Better Health (Medicaid) plans, providers need to use Availity to submit
electronic member eligibility and benefits.
Aetna does not plan to ease policies such as prior authorization requirements to help further ensure member access to care while the service interruption continues.
Related: Hospitals, providers still scrambling to get paid after Change Healthcare cyberattack
“We are not liberalizing any policies at this time,” it said. “We have assessed the situation over the last few days and the alternative processes in place — in addition to available Aetna phone call support — should help us manage this important utilization management step with our network providers during this time. If this changes, we will provide an update.”