Payment of Claims Update for CareFirst Community Health Plan Maryland, CareFirst Advantage DSNP, Inc. and CareFirst Administrators
In the aftermath of the cybersecurity incident at Change Healthcare on February 21, 2024, CareFirst Community Health Plan Maryland (CareFirst CHPMD), CareFirst Advantage DSNP, Inc. (DSNP) and CareFirst Administrators (CFA) remain aware of the impact this external issue is having on the healthcare industry at large.
CareFirst CHPMD, DSNP and CFA used Change Healthcare to issue electronic funds transfer (EFT), paper check payments, and corresponding electronic remits and explanation of payments (EOPs) to providers; however, for these products, electronic and paper check payments for claims have been held since February 21, 2024.
Due to the cybersecurity Incident, Change Healthcare had ceased healthcare payment processing-related operations and was no longer transmitting claims for submission to payers or servicing the funding of such claims. CareFirst CHPMD, DSNP and CFA have actively pursued solutions to ensure providers could continue delivering essential services to our members despite the potential disruption to cash flow. We are happy to share that, for continuity of payment of claims, we have now partnered with Zelis to support select CareFirst products.
To ensure you get paid as soon as possible, all initial payments issued by Zelis will be sent by paper check, along with the EOP.
- For CFA, checks will be sent to the address on the claim.
- For CareFirst DSNP and CareFirst CHPMD, checks will be sent to the address on file with our credentialing team.
These payments will begin in the coming days and then will transition to electronic payments once we are prepared to do so. Recent claims will start to be paid sooner, and February and March claims will follow shortly after.
You will receive these instructions from Zelis too, but we wanted to offer this to our provider network before you hear from Zelis.
How to receive electronic payments for CHPMD, DSNP, and CFA members:
- If you are already part of the Zelis Payments Network, and currently receive electronic payments, no action is needed. Your electronic preferences will be honored.
- Zelis will transfer electronic payments to you for these claims as soon as possible. Zelis will deliver payments using your preferred payment method of ACH+ under your existing terms.
- Zelis has configured a Zelis ePayment Center, where you can register for electronic funds transfer (EFT) and electronic remittance advice (ERA) services from CareFirst at no cost to you. Electronic payments will begin as soon as your setup is complete.
- Additionally, if you would like to enroll into ACH+ through the Zelis Payments Network to streamline your payments and remittances for a small fee. You can customize your payment and data preferences, including clearinghouse delivery, downloadable 835 and other additional digital options. To enroll, please contact Zelis at 1-855-496-1571.
Zelis is only being used for CHPMD, DSNP, and CFA claims. Claims submission and payment remain uninterrupted for other CareFirst products. Maintaining access to healthcare for our members and supporting providers in their ability to offer continuous health services remains a critical priority. We appreciate your partnership as the healthcare industry continues to navigate this situation.