Provider updates

What is the latest update regarding the Change Healthcare cyber security issue?

Change Healthcare identified a significant event on February 21st that caused them to temporarily disconnect their systems to protect sensitive data for members and providers nationwide. At this time, the issue has not been resolved. We are working to establish an alternative connection to receive electronic claims.

Current situation:

• CareOregon has not received electronic claim files (professional, facility, or dental) from our clearinghouse Change Healthcare, since February 20th.
• We understand that this may affect the timeliness of claims submissions. CareOregon will work to resolve any issues with timely filing that may arise.
• CareOregon’s incident management team has been deployed and is monitoring the situation on a daily basis.
• To help us explore alternate solutions, please use the Smartsheet link to provide your EHR, Clearinghouse, and informatics points of contact.
• For more information about this issue, please visit Change Healthcare’s outage updates page.

How does this incident impact the claims payment from CareOregon?

Claims submitted to CareOregon prior to February 20th will be processed as normal. Please continue to monitor your claims status through the Provider Portal.

What claim submission options do I have?

There are several options for providers below.

Direct Data Entry (DDE): Providers can submit claims through direct data entry on the VisiblEDI portal. An instructional guide is available on the port 

SFTP Site (Secure File Transfer Protocol Site): Providers with the ability to log in to a secure SFTP site (hosted by CareOregon’s EDI partner) can deliver an 837 claim file containing only CareOregon billed claims.

Once the 837 files are processed, a claim response file will be delivered to the SFTP site for retrieval (999 and 277CA).

Secure Online Portal: Providers with the ability to deliver an x12 837 claim file containing only CareOregon claims can also deliver those files via a secure online portal (hosted by CareOregon’s EDI partner). Once the 837 files are processed, claim “acceptance” or “rejection” feedback will be available on the portal.

To register please visit CareOregon (visibiledi.com). For further assistance on registration, please call customer service at 503-416-4100 or 800-224-4840.

I don’t use Change Healthcare for my clearinghouse, what will happen to my claims?

If using a clearinghouse outside of Change Healthcare, CareOregon may be able to work with your clearinghouse to redirect claims to our new EDI partner. Please use the link here to provide us with information necessary to explore this option to redirect claims.

As of March 1st, 2024. CareOregon has successfully redirected claims from several clearinghouses. Please see the list of connected clearing houses below. We will update this list as more clearinghouses establish a direct connection.

CareOregon has had no interruptions in receiving crossover claims from CMS (claims billed to Noridian or traditional FFS Medicare) and from OCHIN member clinics who use OCHIN’s clearinghouse, Trizetto Provider Solutions.

Should I send in my claims on paper through the mail?

CareOregon will continue to process paper claims submitted through the mail. We ask that providers first review the electronic options mentioned above to ensure quicker processing times.

CareOregon has scaled up our claims processing team to respond to this issue, but paper claim submissions require direct data entry and may result in longer processing times.

When will this incident be resolved?

CareOregon’s incident management team has been deployed. We continue to monitor updates from Change Healthcare daily. We ask that you monitor the Connect Portal and our website for critical updates.

Will any of my claims get lost?

If you use Change Healthcare as your clearinghouse, we encourage you to resubmit any claims that were initially submitted after February 20th to ensure CareOregon received those claims.

If you do not use Change Healthcare, please monitor the connected clearinghouse list in this FAQ to see the date on which we successfully redirected claims. Any claims that fall within February 20th and the date on which have been successfully redirected should be resubmitted.

If CareOregon has the claim on file, duplicate submissions will be denied.

How do I check status of my claims?

We encourage providers to utilize the Connect Portal available to them. If you would like to sign up for Connect Portal, please register here.

If you are unable to register, please Call Customer Service at 503-416-4100 or 800-224-4840.