The healthcare landscape is no stranger to the challenges posed by cybersecurity threats, and the recent incident involving Change Healthcare has reverberated across the industry, affecting Wellcare and its stakeholders. On February 21, Change Healthcare, a pivotal player in software and data analytics, encountered a cybersecurity breach, prompting Wellcare to take swift action to mitigate potential disruptions to its services.
In response to this incident, Wellcare has taken proactive measures to safeguard its members and providers while striving to maintain operational continuity. Here’s a comprehensive overview of the impact on WellCare’s services and the steps being taken to address the situation:
Electronic Claim Submission: One of the immediate consequences of the cybersecurity incident is the disruption to the ability to electronically submit claims to WellCare through Change Healthcare. However, Wellcare assures its providers that alternative avenues for claim submission are readily available. Providers are encouraged to utilize alternative methods such as other claims clearinghouses, the secure provider portal, fax, or mail. Notably, Wellcare recommends Availity as its preferred clearinghouse for electronic claims submission and offers support for enrollment through Availity Client Services.
Reimbursement via Paper Check and Virtual Credit Card (VCC): The incident has also impacted the paper check and virtual credit card payment processes for Wellcare, potentially causing inconvenience to providers. Recognizing the importance of timely reimbursement, Wellcare is diligently working to implement alternative processes to ensure payments are operational without delay. Providers are encouraged to explore setting up an automated clearing house (ACH) for electronic funds transfer (EFT) to expedite the payment process, with PaySpan (now part of Zelis) identified as Wellcare’s preferred ACH/EFT partner.
Chart Retrieval: Change Healthcare’s role in chart retrieval for various Wellcare programs, including HEDIS® and Risk Adjustment, has been affected by the cybersecurity incident. As a result, Wellcare has enlisted the assistance of its existing medical record retrieval vendors, Datavant (formerly Ciox) and Datafied, to fulfill prior commitments. Providers who have received requests from Change Healthcare for medical records are urged to honor the same commitment dates with the alternative vendors. Additionally, providers may be requested to resubmit medical records for the period affected by the incident.
Source: https://www.wellcare.com/en/providers/medicare-bulletins/change-healthcare-incident
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