Change Healthcare Outage: Provider Resource Center
Oscar is taking proactive steps to limit disruption to members and providers while Change Healthcare systems are offline.
How do I verify patient eligibility?
Providers may verify eligibility by logging into the Oscar provider portal via provider.hioscar.com. They may also continue to call Oscar at 855-672-2755 to verify eligibility via our automated phone system. Please visit hioscar.com/providers and follow these instructions to create a Portal account. If a provider encounters any issues logging into the Provider Portal, they may utilize the Provider Resource page or call Oscar’s Provider Services team at 855-672-2755.How do I submit authorization requests?
Oscar’s authorization request functionality (via portal, fax, and phone) is not impacted, and providers should follow their usual processes to submit authorization requests.How do I submit claims for processing?
In response to the Change Healthcare outage, Oscar has stood up operations with an alternate claims clearinghouse, Availity, to ingest claims. Providers who submit claims through an EHR or clearinghouse that is not Change Healthcare may resume submitting claims through their standard process. Providers who submit claims through Change Healthcare should contact Change Healthcare for support and workaround options. Providers who wish to submit claims by mail can now do so through their standard process. To return additional information requested for claims processing, please utilize Oscar’s Provider Portal or contact Oscar via fax: 888-977-2602Is Oscar able to process claims submitted by mail since the start of the Change Healthcare outage?
Yes. Oscar’s mailroom has resumed normal operations and is receiving and processing claims submitted by mail. Providers may submit claims to Oscar by mail through their standard process. We are in the process of reviewing paper claims submitted since the Change Healthcare outage began on February 21, 2024. Claims will be reviewed and processed in the order received.The Change Healthcare outage endangers my ability to meet timely filing requirements. Can I be granted an exception?
We understand that Change Healthcare’s system outage may impact our provider partners’ ability to meet timely filing requirements. Oscar will provide a timely filing extension of 7 calendar days for claims that would otherwise have been timely submitted if the Change Healthcare outage had not occurred. In other words, we will not deny claims due to a Timely Filing deadline if the deadline falls between February 21, 2024 and March 6, 2024 and we receive the claim by March 7, 2024.How do I access EOPs?
Providers will receive payment for claims ingested prior to the Change Healthcare service outage on February 21, 2024 and any claims Oscar receives through Availity. EOPs: Providers can access EOPs through Oscar’s provider portal. Providers not enrolled to receive electronic remittance advice will continue to receive EOPs through the mail.How do I access remittance guidance?
Providers who are enrolled to receive 835s from Oscar and enrolled in the Availity provider portal will receive 835s via their normal process (their payment system / software). No further action is needed. Providers who are enrolled to receive 835 files from Oscar but do not have Availity provider portal accounts will need to enroll with Availity to receive these files going forward. Please follow the instructions in the question below to enroll. Providers enrolled to receive 835s from Oscar who do not enroll with Availity will receive 835 files once Change Healthcare resumes remittance guidance services. Providers who are not enrolled to receive 835s with Oscar but would like to do so will need to enroll via the Oscar provider portal. Once enrolled to receive 835s from Oscar, providers will follow the instructions in the question below to enroll with Availity.I am enrolled to receive 835s from Oscar. How do I enroll with Availity to receive these files?
Step 1: Register or log in to Availity’s portal- Begin the enrollment process by accessing Availity’s portal, Availity Essentials
- If you do not have an account on Availity’s portal: Follow the prompts to begin the registration process. Availity’s new user guide is here for reference.
- If you already have an account: Log in.
- In the Availity Essentials navigation bar, select My Providers | Enrollments Center
- In the Enrollments Center, click Transaction Enrollment. The Transaction Enrollment - Enrollment Status page displays.
- Follow the prompts in the Availity portal to enroll.
- Note: Your clearinghouse may be able to enroll in the Availity portal on your behalf. Please contact your clearinghouse for support.
- Log in to the Oscar provider portal. Re-enroll by following the below steps:
- Navigate to the “Manage Payments” section of the Oscar Provider Portal
- Locate your enrollment(s) in the table under the “Payment settings” section
- If your enrollment is in a “pending”, “enrolled”, or “under review” state, you can quickly re-enroll with the following steps:
- Select your enrollment to view your payment setup
- On the next screen under “ERA enrollment information”, click “Edit ERA enrollment”
- On the next screen, click the blue “Next: ERA info” button to affirm your settings and proceed
- On the next screen, click the blue “Next: submission info” button to affirm your settings and proceed
- On the next screen, click “Change Enrollment” and e-sign the form, then click the blue “Submit” button to submit your enrollment request
- Availity will update provider enrollment status on a bi-weekly (twice per week) basis.
- Providers can view their submission status on the Availity portal, which will say “Enrollment Complete” once the enrollment is approved.
- No action is needed on the provider’s part at this stage.
- Providers will begin to receive 835s via their normal process (their payment system / software) as soon as they have completed the enrollment process on both Availity and Oscar’s provider portals, even if their enrollment status is pending.
- Providers must enroll through both Availity and Oscar. If enrollment with Oscar is not completed, 835s will not be sent.
- Once enrolled, providers will also be able to view 835s on the Oscar provider portal (Instructions here).