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As you likely know, Change Healthcare publicly announced a cyber security incident last week. We understand many providers who treat patients with a Cigna Healthcare benefit plan work through Change Healthcare to administer electronic services, including claim submissions, eligibility verification, precertification, and other administrative services. The Cigna Group, which includes Cigna Healthcare and Evernorth Health Services, also works with Change Healthcare to facilitate some of these services. The issues they are experiencing are therefore impacting our ability to interface with Change Healthcare.
First, please know that we continue to actively monitor the situation and there are no indications that any Cigna Health Group systems are affected.
As an organization, we are focused on ensuring access to care and medications for our customers and patients while also ensuring that you have alternative options to transact with us as needed. We are also working to resolve any disruption from Change Healthcare’s incident for you, individuals, clients, and other partners as quickly as possible.
What we did when we found out about the incident
After becoming aware of the incident, we immediately severed system connections with Change Healthcare and relevant associate UnitedHealth Group companies (e.g., UnitedHealthcare and Optum) and implemented business continuity planning to ensure there was as limited disruption to our provider partners, customers, and clients as possible.
Network connections were reestablished on February 24 with related UnitedHealth Group companies, which include Optum and UnitedHealthcare. This decision was made after conducting additional investigation and receiving validation from the UnitedHealth Group that these companies were not impacted by the cyber incident. However, our connections to Change Healthcare systems remain severed as they work to resolve this issue, and there is currently no estimated date for restoration.
Submitting claims to Cigna Healthcare
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We encourage all commercial and Medicare Advantage providers to utilize the many alternative digital trading partners we offer to submit claims directly to Cigna Healthcare. Please know that we have been in direct contact with these vendors and are confident in their ability to support your digital transactional needs in a timely manner. |
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Commercial providers also have the option to submit paper claims to us through typical claims addresses and can access Explanation of Payments (EOPs) and Direct Deposit Activity Reports (also known as remittance reports) on CignaforHCP.com to reconcile their payments. |
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Cigna Healthcare Medicare Advantage uses Change Healthcare to issue electronic funds transfer (EFT), paper check payments, and corresponding electronic remits and EOPs to providers. As a result of severing system connections with Change Healthcare, EFT and paper check payments for Medicare Advantage claims have been held since February 21, 2024. Please be assured that we are quickly working on an alternative solution to ensure you are paid in a timely manner and remain committed to working with you to reconcile claims and payments, as needed. We appreciate your patience and will update you soon. |
Alternative options to check patient eligibility
Cigna Healthcare continues to offer two primary alternative options for providers to check eligibility and benefits information for their patients with a Cigna Healthcare benefit plan:
Option one (online)
Commercial providers | Verify patient eligibility and verify patient and plan detail information on CignaforHCP.com.
Medicare Advantage providers | Verify patient eligibility and verify patient and plan detail information on the HSConnect Provider Portal.
Option two (automated phone)
Commercial providers | Call Cigna Healthcare Customer Service at 800.88Cigna (882.4462).
Medicare Advantage providers | Call Cigna Healthcare Customer Service at 800.230.6138.
Please note that for our Third-Party Administrator accounts (e.g., Shared Administration Repricing and Payer Solutions), providers should continue to verify eligibility by calling the number on the back of the patient’s ID card.
Answers to commonly asked questions
We appreciate that your day-to-day operations, like ours, may be impacted by the Change Healthcare outage. However, the incident at Change Healthcare has not affected our ability to operationally receive, process, respond to, review, or approve various provider requests, including those about precertification, admissions, and utilization management reviews.
Therefore, Cigna Healthcare’s existing requirements remain in place with no changes at this time. While we continue to monitor the situation closely, and may update some of our guidance if Change Healthcare remains down for an extended period of time, we are not making any changes to the following requirements at this time:
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Precertification (i.e., authorizations) |
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Timely filing |
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Facility-to-facility transfers and related authorizations |
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Admission notifications |
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Eligibility reviews |
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Utilization management review |
Precertification
Precertification continues to be an important way to ensure that your patients’ care will be covered under their specific benefit plan. The precertification process also helps direct participants to various support programs, including wellness coaching, chronic condition coaching, and case management.
As noted above, the incident at Change Healthcare has not impacted our ability to receive, process, or approve precertification requests. Therefore, Cigna Healthcare’s precertification requirements remain in place with no changes at this time (including for facility-to-facility post-acute transfers). Providers are encouraged to continue to use standard channels to request precertification through Cigna Healthcare and related Cigna Group companies.
Cigna Healthcare (commercial)
• CignaforHCP.com > Precertification process
• 800.88Cigna (882.4462)
Cigna Healthcare (Medicare Advantage)
• HSConnectOnline.com
• 800.668.3813
eviCore healthcare*
• eviCore.com/provider
• 800.918.8924
Keeping you informed
It’s unclear how long this outage will remain in place. We continue to stay in touch with Change Healthcare and have requested a timing estimate for restoration of their site. As always, we remain committed to keeping you informed as we learn more or as we update the guidance noted above.
In the meantime, if you have any questions, feel free to engage us as you do today through your standard channels, and we will answer as best we can.
Thank you for the care you provide our customers.
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