Welcome, Providers

Change Healthcare System Interruption

Change Healthcare, our electronic data interchange (EDI) clearinghouse for claims and payment cycle management, informed us of a network interruption related to a security incident. Change Healthcare took immediate action to disconnect their systems to mitigate further impact. At this time, there is no indication that our member data or systems have been impacted.

In an abundance of caution, we disabled connectivity between our systems and Change Healthcare's impacted systems. This interruption has had downstream impacts to our plan and the provider community, including:

  • Our ability to:
    • Receive electronic claim transactions
    • Remit claim payments and remittance advice, both electronic and paper
  • Providers' ability to:
    • Submit claims directly to Change Healthcare via NaviNet ConnectCenter, EDI vendors, or practice management systems
    • Access and view some electronic remittance advice in NaviNet

We understand this could present a hardship for our provider community and appreciate your patience. Once electronic claims submission functionality resumes, we will process all claims received as quickly as possible.

Eligibility verification, claim status inquiry, and authorization inquiry via NaviNet are still available. If you do not currently have access to the NaviNet provider portal, please visit https://register.navinet.net to sign up.

Please note, in the interim our Provider Services Department will not be able to assist with processing of your payments any sooner. If you have other questions, you may contact Provider Services at 1-800-521-6007.

We thank you for your partnership and will keep you informed as we learn more.

Public health emergency ending: What you need to know

As you know, the Pennsylvania Department of Human Services (DHS) was able to keep Medical Assistance (MA) coverage open for most people during the COVID-19 Public Health Emergency (PHE) even if they were no longer eligible for MA. DHS is now in the process of making sure that everyone who is receiving MA is still eligible by reviewing each person’s information.

What your MA patients need to do and how you can help

Important information

Quick contact information

For additional information on Community HealthChoices, visit the Department of Human Services’ Community HealthChoices information page and list of publications.