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.

Latest updates

November 25, 2024

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:

• Health care claim status request and response transactions (i.e., 276/277s) were reconnected on October 7.
• Eligibility and benefits transactions (i.e., 270/271s) were reconnected on October 22.

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.

Previous updates

May 2, 2024

Zelis continues to issue payments for all claims

As a reminder, we have partnered with Zelis to issue payments for all claims submitted to Cigna Healthcare Medicare Advantage, including any outstanding claims that you previously submitted:

• To Change Healthcare prior to February 21;
• To another vendor (e.g., Availity); or
• Directly to Cigna Healthcare Medicare Advantage

Zelis is also responsible for issuing payments for any new claims that you submit directly to us or through another vendor.

Latest updates

• Please note that retroactive 835s are available through Availity for any paper checks received to date. If you are not currently signed up with Availity, the 835 file will not initially be available.
• Current electronic funds transfer (EFT) and electronic remittance advice (ERA) services are available through Zelis.

Receive digital payments

• Zelis set up a Zelis ePayment Center, where you can register for electronic funds transfer (EFT) and electronic remittance advice (ERA) services from Cigna Healthcare Medicare Advantage at no cost to you. Electronic payments will begin as soon as your setup is complete.

• If you haven’t already, you can upgrade to ACH+ through the Zelis Payments Network and streamline your payments and remittances from an additional 450+ payers through a single portal. You can customize your payment and data preferences, including clearinghouse delivery. Virtual cards are also available. To enroll, please contact Zelis at 1.855.496.1571.

• Please note that if you are already part of the Zelis Payments Network and currently receive electronic payments from them, Zelis will transfer you to electronic payments for these claims as soon as possible, and no action is needed by you.

Reconnecting our system with Change Healthcare

At this time, Change Healthcare has not fully restored their impacted environment, but has shared that they are working on multiple approaches to restore services and reconnect with customers and partners in the coming weeks.

Please know that Cigna Healthcare has high standards for security from all vendors and will only reestablish connection with Change Healthcare services when proper validation of the security of their environment has been determined. This cannot take place until after Change Healthcare has indicated that they have securely and successfully restored their impacted services to the satisfaction of The Cigna Group’s standards for security.

Therefore, we cannot commit to a specific timeline right now for when Cigna Healthcare’s systems will be reconnected to Change Healthcare. As a result, certain claims submitted to Change Healthcare on (or just prior to) February 21 may not have a payment released until Change Healthcare is back online and we reconnect our systems to them.

We also recognize and appreciate that many providers have switched to a new claims clearinghouse and may have already resubmitted claims that were previously submitted to Change Healthcare. Payments received from another clearinghouse will be released by Zelis in accordance with what was described above.

Additional information

As a reminder, we encourage you to continue to work through an alternative vendor to submit claims (i.e., 837 transactions) to us while our systems remain severed to Change Healthcare. For a list of alternative vendors to work with, please visit medicareproviders.cigna.com > View Provider Manual (pages 13–15).

If you have any questions about Cigna Healthcare’s reaction to the Change Healthcare incident, please contact your Provider Relations Representative or Provider Customer Service at 800.230.6138. If you have any questions about Zelis’ new payment options, please contact them at 833.306.0337.