Tebra Status

Investigating: Tebra's eRx enrollment verification vendor is currently experiencing a service interruption which is impacting eRx enrollment submission and status verifications. Tebra is working closely with our partner to get this resolved as soon as possible. We apologize for any impact this causes to your business and will keep you updated on our progress.

Thank you for your understanding.

Monitoring: Update as of 08/29/2024 - We would like to share a quick update on how things are progressing in light of the cybersecurity incident that affected Change Healthcare. It's been six months since the cyber attack, and we appreciate that there are still lingering effects being felt by Tebra customers and others in the healthcare industry. Visit https://helpme.tebra.com/Update_Ongoing_Impact_of_the_Change_Healthcare_Outage to learn more about the steps we’re taking to support you through this challenging time.

We’ve also updated our impacted payer list to include ERA connection details. You can view the updated list at https://tebra.co/change-impacted-payers.

Investigating: Change Healthcare outage update as of 5/8/2024

Important Update for Customers Enrolled through Capario/Change Healthcare: Tebra is thrilled to announce that after more than 2 months of Change Healthcare being offline, we have reconnected and will resume submitting claims and routing inbound ERAs. Our teams worked diligently behind the scenes to find solutions, innovate, and try to mitigate the impact of this unprecedented event to your business and clients.

Starting April 26th, Change Healthcare began routing ERAs to us and we were able to find an alternate pathway for delivering them to their corresponding accounts. As of today, customers with legacy payer connections through Capario can expect to receive claim status reports and other essential clearinghouse reports. Claims submitted around February 21st may be rejected as a duplicate, but please confirm the status with the payer before re-billing claims to avoid further rejections or denials.

While there’s been significant progress, it’s important to note that not all payers are online with ERAs just yet, resulting in further manual payment posting. Tebra continues to work closely with our TriZetto and Change Healthcare partners to receive timely updates on ERA reconnections. Your patience and understanding during this process are greatly appreciated.

Impact to customers enrolled through Trizetto We are working with the TriZetto team to prepare an update for our users enrolled through TriZetto. In the meantime, we continue to update the list of affected payers as updates are received. You can view the list here: https://tebra.co/change-impacted-payers. Please remember that, while claim connections have been restored, ERAs and Eligibility remain affected for all payers on the list.

Investigating: Change Healthcare outage update as of 4/25/2024

Important Update for Customers Enrolled through Capario/Change Healthcare: Tebra is now submitting the backlog of claims for further processing through Capario/Change Healthcare. These specific claims were on hold because Tebra could not identify an alternative submission pathway, due to the associated payers requiring enrollments for e-claim submissions. Although previously reported, Tebra did not receive claim status reports for the first wave of claims. We are working to provide claim status reports for all submitted claims, which we expect to have in the upcoming week.

Impact to customers enrolled through Trizetto: As we gather more information from Trizetto, we will update the list of affected payers. You can view the list here: https://tebra.co/change-impacted-payers. While claim connections have been restored, ERAs and Eligibility remain affected for all payers on the list.

We would like to add additional clarity to new payer enrollments that remain on hold, despite the payer not being identified as an impacted payer. Please note that Trizetto’s primary focus has been to restore claims pathways, which means that enrollment processes may not be re-established for some resolved payers. Users are encouraged to continue to submit enrollment requests so that Tebra’s Enrollment team can begin facilitating those requests once each payers’ enrollment processes become available.

Investigating: Change Healthcare outage update as of 4/22/2024

Important Update for Customers Enrolled through Capario/Change Healthcare: Tebra has successfully tested a temporary connection to submit claims that were delayed due to the recent cyberattack on Change Healthcare. These specific claims were on hold because Tebra could not identify an alternative submission pathway, as the associated payers required enrollments for e-claim submissions. We expect to send out these impacted claims this week for customers using Capario/Change Healthcare for e-claim submissions. As we clear the backlog, you will receive claim status reports showing if your claims were accepted or rejected.

Please be aware that while we have restored claim connections, this is only temporary. Change Heathcare’s work to restore Eligibility and ERA connections has not yet started. We will keep you informed of any progress as Change Healthcare continues their restoration efforts.

Impact to customers enrolled through Trizetto:

As we gather more information from Trizetto, we will update the list of affected payers. You can view the list here: https://tebra.co/change-impacted-payers. While claim connections have been restored, ERAs and Eligibility remain affected for all payers on the list.

Investigating: Change Healthcare outage update as of 4/05/2024

Impact to customers enrolled through Trizetto: As Trizetto and other clearinghouses continue to reconnect with previously blocked payers, the list of impacted payers has rapidly decreased, with more than 200 payer connections reported as being reestablished today. We will continue to update the list of blocked payers as we receive this new information.

You can review the impacted payer list at: https://tebra.co/change-impacted-payers. Reminder: payer connections that have been restored are for claims traffic only; ERAs & Eligibility remain impacted for all payers on the impacted list.

Investigating: Change Healthcare outage update as of 3/29/2024

This week, Change Healthcare made an announcement regarding the restoration of their largest clearinghouse, Relay Exchange. While the reactivation of Relay Exchange is undoubtedly positive news, there remains a significant amount of work ahead to fully restore the flow of claims, ERAs, and eligibility transactions. Change Healthcare has initiated efforts to reach out to payers and other clearinghouses in order to expedite the reestablishment of connections, with this, progress is being made towards rebuilding connectivity to those connections as well as third-party vendors. We find this development encouraging as it indicates that the backlog of connections is gradually being addressed.

Impact to customers enrolled through Trizetto: As Trizetto and other clearinghouses begin reconnecting with the payers that were previously blocked, we anticipate a more rapid decrease in the list of impacted payers in the upcoming weeks. Currently, we do not have information on which payers will be reconnected or the precise time frame for when transactions will resume, but we will diligently update the list as we receive new information. You can review the impacted Payer list at: https://tebra.co/change-impacted-payers

Impact to customers enrolled through Capario/Change Healthcare: While some of Change Healthcare's connections have been reinstated, the connection for our legacy Capario payer IDs is still in progress. Change Healthcare has arranged a webinar for next week where we anticipate gaining further insight into their strategy for restoring our clearinghouse. In the interim, claims that do not require enrollment will continue to be forwarded to Trizetto. However, claims for payers necessitating enrollment, along with ERAs and eligibility transactions, remain blocked. We will provide updates next week as soon as we have new information to share.

Investigating: Change Healthcare outage update as of 03/22

As Change Healthcare’s Eligibility, Claims, and ERA transactions continue to be down, we have been working with Change Healthcare to better understand the timeline for reestablishing connections to submit claims, check eligibility, and receive ERA transactions for all affected payers.

Impact to customers enrolled through Trizetto: Our teams are continuing to communicate closely with our Trizetto contacts to understand impacts to intermediary connections. Trizetto has begun communications with Change on reconnection with Relay Exchange and Assurance for intermediary transactions. We anticipate more details on payer-specific impact in the coming week. Please continue to monitor the Impacted Payer list (https://tebra.co/change-impacted-payers) as we continue to make regular updates as we receive them from our partners at Trizetto. Note that the payer connections that have been restored are for claims traffic only, ERAs & Eligibility remain impacted for all payers on the list.

Impact to customers enrolled through Capario: While some Change Healthcare connections are being tested and brought back online this weekend and next week, legacy Capario payer IDs are not included in next week's activity and Change Healthcare is unable to provide a date that this connection will be brought back online. In light of the lack of a clear timeline to restore service, the Tebra team is actively working on options for long-term solutions for practices submitting claims directly to Capario. Claims not requiring enrollment will continue to be forwarded to Trizetto, but claims for payers requiring enrollment—in addition to ERAs & Eligibility transactions—remain blocked.

For legacy customers with electronic payer connections through Capario who are considering transitioning enrollments to Trizetto, please note we are experiencing a higher volume of enrollment requests due to the Change Healthcare outage. We are doing our best to review and submit the enrollment requests that are being received as a result of this outage.

Investigating: Change Healthcare outage update as of 3/18/2024

As Change Healthcare’s Eligibility, Claims, and ERA transactions continue to be down for the third week, we have been working with Change Healthcare to better understand the timeline for reestablishing connections to submit claims, check eligibility, and receive ERA transactions for all affected payers.

By the end of the week, we expect Change Healthcare’s largest clearinghouse, Relay Exchange, will be back online. Reconnection will begin with providers, including Assurance customers, channel partners and other clearinghouses, to enable claim submission to payers. Claims prepared in Assurance will not be released to payers until this happens. We will provide further updates once we understand how our clearinghouse partners are impacted by this reconnection.

Currently, Tebra is not included in the reconnection phase planned for this week, but we continue to work closely with Change Healthcare to establish a clearer timeline for reconnecting services. We are also working with Trizetto to continue to identify alternative routes to submit claims. Trizetto has been successful in routing claims traffic for additional payers, which we have updated in our list of impacted payers (https://tebra.co/change-impacted-payers). Please refer to the list of impacted payers (https://tebra.co/change-impacted-payers) to view the latest updates from Trizetto regarding the payers they’ve successfully rerouted.

For legacy customers with electronic payer connections through Capario that are considering transitioning enrollments to Trizetto, please note we are experiencing a higher volume of enrollment requests due to the Change Healthcare outage. This may lead to longer enrollment processing times, which may delay your ability to submit claims or receive ERAs. We are doing our best to review and submit the enrollment requests that are being received as a result of this outage

Investigating: Updates as of 3/14/2024 - Updates regarding Change Healthcare outage and Payer Communication

(Critical) Payer Communication:

As Change Healthcare’s Eligibility, Claims, and ERA transactions continue to be down for the third week, we have seen an influx in payer communications instructing providers to re-enroll for transactions through their portals. While this process could unlock the ability to manually submit claims, pull down EOBs, and manually check Eligibility, these re-enrollment processes will cause disruptions that will create a lasting impact to practice operations, beyond when the Change Healthcare systems come back online. It’s Tebra’s recommendation to our customers to please disregard these instructions, unless absolutely required, as it will sever the ties between your Practice Management application and the payer systems. Please note, if you complete a portal enrollment, a new enrollment through any clearinghouse will be required to reestablish electronic transmission of Claims, Eligibility, and Remittance files. If you have already completed these enrollments, a new enrollment request will need to be submitted once payer connectivity is reestablished. Please refer to the following help article (https://helpme.tebra.com/Tebra_PM/04_Settings/Electronic_Data_Interchange_(EDI)_Enrollment/Enroll_for_Electronic_Insurance_Services) for more details on Enrollments.

Change Healthcare Status Update:

Change Healthcare is preparing to test and reestablish connectivity the week of March 18th. At this time, we do not know the Claim or ERA experience for transactions that had not made it through the processing lifecycle at the point their systems went offline. At this time, we recommend that customers prepare for mass rebill actions for denied claims, appeal processes for timely filing limits, and an abundance of missing ERA/payment reconciliation efforts.

Tebra has a scheduled call with Change Healthcare’s executive leadership team on the afternoon of March 15th. We hope to have a more comprehensive update for our customers after that meeting.

Investigating: UPDATE AS OF 3/12/2024 - We have some important updates to communicate today: Trizetto was able to complete the connection for Payer ID 22099 (Blue Cross Blue Shield of New Jersey - Horizon). For our clients who leverage Trizetto (Gateway EDI) as their clearinghouse, any outstanding and/or rejected claims should be resubmitted.

The Centers for Medicare & Medicaid Services (CMS) announced new advanced payment financial assistance programs for providers whose revenues were impacted by the Change Healthcare cyberattack. Providers are eligible for 30 days of Medicare payments based on the total claims paid to the provider/supplier between August 1, 2023, and October 31, 2023, divided by three. You can learn more about the program details as well as the associated fact sheet: https://www.cms.gov/newsroom/press-releases/cms-statement-continued-action-respond-cyberattack-change-healthcare

Additionally, CMS announced today that they have extended the data submission period for the Merit-based Incentive Payment System (MIPS)-eligible clinicians who participated in the 2023 performance year of the Quality Payment Program (QPP). Data can now be submitted and updated until 8pm ET on April 15, 2024. You can visit https://qpp.cms.gov/ to learn more.

Change Healthcare announced that they expect to begin testing and reestablish connectivity to their claims network and software on March 18, restoring service through that week. You can read more about their announcement here: https://www.unitedhealthgroup.com/ns/changehealthcare.html. We expect that once their service is restored, it may take additional time for workflows to resume to their normal working conditions. We remain in contact with Change Healthcare and Trizetto so that we can stay up to date with their resolution timeline.

Investigating: UPDATE AS OF 3/8/2024 - Change Healthcare announced that they expect to begin testing and reestablish connectivity to their claims network and software on March 18, restoring service through that week. You can read more about their announcement here: https://www.unitedhealthgroup.com/ns/changehealthcare.html. We expect that, once their service is restored, it may take additional time for workflows to resume to their normal working conditions. We remain in contact with Change Healthcare and Trizetto so that we can stay up to date with their resolution timeline.

Investigating: UPDATE AS OF 3/7/2024 - Change Healthcare continues to experience an interruption in service to eligibility checks, claim submissions, clearinghouse reports, and electronic remittance (ERA) processing for certain payers. As of today, Tebra has updated our list of impacted payers (https://tebra.co/change-impacted-payers) to include all the information we have available about payer status.

Tebra was informed that affected providers who leverage Trizetto (Gateway EDI) with connections to Change Healthcare may be eligible to receive funds through the Optum assistance program. For more information, or to check fund eligibility, please visit https://www.optum.com/en/business/providers/health-systems/payments-lending-solutions/optum-pay/temporary-funding-assistance.html. Providers will be required to log in and check for funding already set up for them. If funds are not available, you will need to fill out the request form.

Investigating: UPDATE AS OF 3/5/2024 - Change Healthcare continues to experience an interruption in service to some eligibility checks, claim submissions, clearinghouse reports, and electronic remittance (ERA) processing. Trizetto continues to establish new connections for payers, with Tebra updating our list of impacted payers (https://tebra.co/change-impacted-payers) with the most updated information so that users can further review when their payers are ready to have claims resubmitted.

Change Healthcare is working on an alternate system to restore claim submission and remittance processing services through another unaffected clearinghouse subsidiary they own, Optum Intelligent EDI (IEDI). Tebra is working with our partners at Change Healthcare on the timing and how to restore payer connectivity at this point in time. When we have more information about availability, we will provide it.

Investigating: There are a number of updates for our clients who leverage Trizetto (Gateway EDI) as their clearinghouse as well as those who leverage Change Healthcare (Capario) directly. For our clients connected directly through the legacy Change Healthcare clearinghouse integration, Optum Financial Services is ready to assist providers depending exclusively on the Change system to collect weekly funds to aid the situation until payment services resume. Once the system is back to normal, funds will need to be returned. For more information about the Optum assistance program, or fund eligibility check, visit https://www.optum.com/en/business/providers/health-systems/payments-lending-solutions/optum-pay/temporary-funding-assistance.html. Providers will be required to log in and check for funding already set up for them. If funds are not available, you will need to fill out the request form. It is unclear if this program will be available to affected providers who leverage Trizetto (Gateway EDI) with connections to Change Healthcare.

For clients connected directly to Trizetto, Trizetto moved three payers to new connection paths thus far: Fallon Community Health, MVP Health Plan of New York and Meritain Health of Minneapolis. Clients will see a rejection message in the transaction ledger as well as receive a claims processing report for affected claims: “TPS has established a new connection please resubmit.” Rejected claims will need to be resubmitted. All net new claims will process with these payers as normal. Trizetto continues to work to establish new connections, with the expectation that they will begin with their largest volume payers. We are currently awaiting clarification on the payers they expect to connect to this weekend, and will provide this information when available. Once connected, any claims that are currently submitted to and held by Trizetto will be processed.

Claims for remaining payers will be rejected by Trizetto in order to give providers the option to submit claims via a different route—either via direct data entry (DDE) on the payer’s web site or a paper-based claim. When rejected, clients will see the message “This payer has been impacted by the Change Healthcare cyber incident. Providers will need to submit by paper, hold or utilize the payer’s DDE” in the transaction ledger/claims processing report. Once Trizetto re-establishes the remaining connections, providers will need to resubmit any previously rejected claims that were not submitted through a different route.

If you choose to hold claims for affected payers while awaiting further clarification about new connections, Tebra suggests that you contact those payers and understand their exception policy in regards to the Change Healthcare outage and their timely filing requirements. If no exceptions are being made, it would be prudent to work with the payer to upload claims directly via their portal (a form of “direct data entry” or “DDE”) and to confirm that this will not override electronic enrollment capabilities.

As Tebra learns more details about new payer connections and what is permitted, we will continue to share that information here.

Investigating: Tebra has worked with Trizetto to compile a list of impacted payers https://tebra.co/change-impacted-payers. While Tebra has not received payer details directly from Change Healthcare, and their payer list isn’t currently accessible online, we have been working closely with our clearinghouse partner to compile who we may believe to be impacted at this point in time.

We would like to provide an update to the Change Healthcare clearinghouse outage that has caused an interruption in service to some eligibility checks, claim submissions, clearinghouse reports, and electronic remittance (ERA) processing. If you were not previously aware, Change Healthcare’s clearinghouse services are currently experiencing a disruption due to a cyber security incident on February 21, 2024. Change Healthcare has confirmed that Optum payer connections are back up and running as normal, but that Change Healthcare and McKesson payers remain impacted. While Tebra uses Trizetto as its primary clearinghouse, this impacts Tebra’s operations as Change Healthcare works with Trizetto as an intermediary clearinghouse to connect with certain payers.

In order to help process as many claims as possible in a timely manner, Tebra is working with Trizetto to reroute claims that do not require an eClaim enrollment or routing through Change or McKesson intermediaries. Tebra will not be able to reroute ERAs and eligibility transactions as enrollments are required for these transactions.

Tebra continues to actively work with both Change Healthcare and Trizetto to understand when customers should expect a full resolution. We ask that users please continue to submit claims for processing to ensure that time stamps remain accurate. Our teams are working together to adjust workflows to minimize disruption as much as possible, but expect that customers may continue to experience timeout errors with some eligibility checks as well as delays in receiving payments on claims.

We will continue to update users once we receive further details about the situation as well as a resolution timeline.

Investigating: Change Healthcare clearinghouse outage

We would like to provide an update to the Change Healthcare clearinghouse outage that has caused an interruption in service to some eligibility checks, claim submissions, clearinghouse reports, and electronic remittance (ERA) processing. If you were not previously aware, Change Healthcare’s clearinghouse services are currently experiencing a disruption due to a cyber security incident on February 21, 2024. Change Healthcare has confirmed that Optum payer connections are back up and running as normal, but that Change Healthcare and McKesson payers remain impacted. While Tebra uses Trizetto as its primary clearinghouse, this impacts Tebra’s operations as Change Healthcare works with Trizetto as an intermediary clearinghouse to connect with certain payers.

In order to help process as many claims as possible in a timely manner, Tebra is working with Trizetto to reroute claims that do not require an eClaim enrollment or routing through Change or McKesson intermediaries. Tebra will not be able to reroute ERAs and eligibility transactions as enrollments are required for these transactions.

Tebra continues to actively work with both Change Healthcare and Trizetto to understand when customers should expect a full resolution. We ask that users please continue to submit claims for processing to ensure that time stamps remain accurate. Our teams are working together to adjust workflows to minimize disruption as much as possible, but expect that customers may continue to experience timeout errors with some eligibility checks as well as delays in receiving payments on claims.

We will continue to update users once we receive further details about the situation as well as a resolution timeline.

Investigating: We are continuing to investigate this issue.

Investigating: Tebra has been notified that one of our ecosystem vendors is experiencing an interruption in service that may affect eligibility checks, claim submissions, and electronic remittance (ERA) processing. Yesterday, out of an abundance of caution, Change Healthcare shut down its services to address a potential security incident. While Tebra uses Trizetto as its primary clearinghouse, this impacts Tebra’s clearinghouse process as Change Healthcare works with Trizetto as an intermediary clearinghouse to connect with certain payers.

Rest assured that Tebra’s Security Team has performed a thorough review of our own systems and found no indicators of attack on Tebra’s direct systems. Our Security Team remains vigilant and will continue to monitor the situation.

Tebra is actively working with both Change Healthcare and Trizetto to understand when customers should expect a resolution as well as to gain an understanding of the scope of the impact. Their teams are working to adjust workflows to minimize disruption, but expect that customers may experience timeout errors with some eligibility checks as well as delays in receiving clearinghouse tracking numbers or ERAs.

We will update users once we receive further details about the situation as well as a resolution timeline.