As you know, the Change Healthcare cyber incident continues to affect Cigna Healthcare, third party vendors we work with, and health care providers – as we collectively rely on Change Healthcare to administer electronic services, including claim submissions, eligibility verification, and other administrative services. 

Since their system outage in February, Change Healthcare has been working diligently to restore their systems and create a safe environment that The Cigna Group can reconnect to. At the same time, Cigna Healthcare has maintained that they have high standards for security from all vendors and will only reestablish connection with Change Healthcare services after proper validation of the security of Change Healthcare’s environment has been determined.

Reconnecting with Change Healthcare for certain systems and services

We are pleased to share that the necessary security validations have taken place for certain systems, and Cigna Healthcare Medicare Advantage has successfully reconnected with Change Healthcare for the following services:

• Eligibility and benefits transactions (i.e., 270/271s) were reconnected on October 22.
• Health care claim status request and response transactions (i.e., 276/277s) were reconnected on October 7.
• Electronic remittance advice (ERA) transactions (i.e., 835s) were reconnected on August 6 for Medicare Advantage Arizona HMO plans only. For all Medicare Advantage plans other than Arizona HMO, please see the information below.

Reconnecting with Change Healthcare for electronic remittance advice (ERA) transactions

As a reminder, we partnered with Zelis in March 2024 to issue payments for all claims submitted to Cigna Healthcare Medicare Advantage, including any outstanding claims that providers previously submitted directly to Cigna Healthcare Medicare Advantage, to another vendor (e.g., Availity), or to Change Healthcare (prior to when they went offline on February 21).

Zelis is also responsible for issuing payments for any new claims that providers submit directly to Cigna Healthcare Medicare Advantage or through another vendor. Importantly, Zelis is able to generate ERAs for all claims they issue payments for.

Obtaining ERAs for Cigna Medicare Advantage claims

Please note that Change Healthcare does not have ability to regenerate historical ERAs for Cigna Healthcare Medicare Advantage claims. Therefore, Cigna Healthcare Medicare Advantage will not be able to reconnect directly with Change Healthcare for ERAs.

However, while Cigna Healthcare Medicare Advantage cannot connect directly to Change Healthcare to provide ERAs, Cigna Healthcare Medicare Advantage began sending ERAs to Zelis as of March 2024. Therefore, because Zelis is connected with Change Healthcare, providers can receive certain Cigna Healthcare Medicare Advantage ERAs through Change Healthcare.

• For claims submitted prior to March 2024 | ERAs for these claims are unfortunately not available. For help with these claims, please contact the Cigna Healthcare Medicare Advantage Provider Service Team at 800.230.6138.
• For claims after March 2024 | ERAs for these claims are available through Zelis, who can pass them through to Change Healthcare. To access these ERAs, please contact Zelis at 855.496.1571 before reconnecting with Change Healthcare.

For providers who choose to use Change Healthcare to receive ERAs from Cigna Healthcare Medicare Advantage

• Providers who were previously enrolled with Change Healthcare, but are not receiving current ERAs, please contact Zelis at 855.496.1571 before re-enrolling with Change Healthcare for ERAs.
• Providers who were previously enrolled with Change Healthcare and are looking for historical ERAs prior to March 2024, please contact the Cigna Healthcare Medicare Advantage Provider Service Team at 800.230.6138.
• Providers who were not previously enrolled to receive ERAs from Cigna Healthcare Medicare Advantage, please contact Zelis at 855.496.1571 before enrolling with Change Healthcare.

Reconnecting additional systems through Change Healthcare

Cigna Healthcare also continues to work with Change Healthcare to reconnect additional services, including claim submissions (837) for U.S. Commercial, IFP, and Medicare Advantage. We expect 837s to be available over the next month, with certain remaining systems to follow by end of year.

Keeping you updated

We appreciate providers’ patience with us and Change Healthcare as the industry collectively recovers from the cyber security incident. We will keep you updated with the latest restoration efforts as new information becomes available.