We understand that the cybersecurity incident at Change Healthcare is leading to significant disruption to routine business interactions between some health care providers and Blue Cross Blue Shield of Massachusetts.
We want to assure you this is not a Blue Cross Blue Shield of Massachusetts cyber incident. We continue to conduct all business operations, such as processing claims, benefits and eligibility verification, and referral and authorization requests by a variety of other methods.
We know that Change Healthcare has said it has reestablished claims submission services for some of its clients. Blue Cross Blue Shield of Massachusetts will not reconnect to Change Healthcare, including the ConnectCenter application, until we have conducted a rigorous security and risk assessment to protect our systems, and our member and provider data.
We recommend that you pursue one of the options offered below as an alternative while Change Healthcare does not have access to our systems. We do not know how long the event at Change Healthcare will interrupt their service to you.
Blue Cross Blue Shield of Massachusetts has partnered with the Mass Collaborative to establish the Change Healthcare Assistance Program (CHAP) — to help providers quickly identify claim submission solutions for your organization. The Center offers technical support to any provider affected by Change Healthcare’s outage.
The program offers:
Contact the Change Healthcare Assistance Program
We are supporting our participating providers who have been affected by the Change Healthcare incident by temporarily waiving the following for provider-submitted claims for our commercial, Medicare Advantage and Federal Employee Program plans.
We will continue to evaluate the situation regularly and will notify you before resuming our standard filing limit.
Option 1 - Use an alternative clearinghouse
We have existing relationships with the following clearinghouses and can accept HIPAA-compliant 837 claims transactions through them.
Important Update: Change Healthcare has stated that it expects its clearinghouse, Relay Exchange, to be back online soon as one option for providers to use for the submission of electronic claims. Blue Cross Blue Shield of Massachusetts cannot reconnect to Relay Exchange until we have completed a rigorous security and risk review for the protection of our members, our provider partners, and our systems and data. We will continue to update our provider partners on the situation with Change Healthcare on this page. We encourage our provider partners to use the alternative methods listed below to conduct business with us.
| Medical | Dental | |
|---|---|---|
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Please note: Blue Cross Blue Shield of Massachusetts does not have a preferred clearinghouse for claims submission. Choosing one of the solutions listed above is a business decision to be made by each provider. You may want to consult with your practice management software company to determine which clearinghouse, if any, their application works with.
About 835 remittances
All 835 claim remittances created since February 21, 2024 have been stored. In light of the Change Healthcare outage, if you’d like, we can send 835 claim remittances to an alternative clearinghouse of your choice to enable you to reconcile your records. (Please note: You must first be enrolled to receive 835 remittances from the recipient clearinghouse.)
! Your EFT payments are not impacted. Payments are sent directly from Blue Cross Blue Shield of Massachusetts, and the online advisories can still be accessed in Payspan.
Option 2 - Submit claims electronically directly to Blue Cross Blue Shield of Massachusetts
All health care providers in our network who can create a HIPAA-compliant 837 can submit claims directly to Blue Cross Blue Shield of Massachusetts for free by following these steps:
Note: If you directly enter claims into ConnectCenter, this might not be an option for your practice. Building an 837 file is a complex task and often requires specialized software.
Option 3 – Mail in a paper claim
You can mail claims on paper to Blue Cross Blue Shield of Massachusetts at the addresses listed below. Please note that processing paper claims will take at least 30-45 days. For faster payment, we recommend using one of the options listed above.
Mail addresses:
| 1500 form | UB-04 form | ADA 2019 form |
Blue Benefit Administrators of MA (BBA) |
|---|---|---|---|
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Blue Cross Blue Shield |
Blue Cross Blue Shield |
Blue Cross Blue Shield |
Blue Benefit Administrators of MA |
Paper forms can be purchased at most office supply stores.
If you have questions, please call Provider Self Service at 1-800-771-4097, option 2.
If you have questions about your Blue Benefit Administrators of Massachusetts claims, visit our BBA page, or call 1-877-707-BLUE (2583).
Our Payspan and InfoDial applications are not affected by the event at Change Healthcare. You can continue to use those applications to review claim details.
Dental providers: If you cannot use Payspan or InfoDial, please call Dental Provider Services at 1-800-882-1178, option 3 to check claims status.
We have existing relationships with the following clearinghouses. These clearinghouses can submit HIPAA compliant 270 eligibility transactions to us.
| Clearinghouses for both medical and dental providers | Dental-specific clearinghouses | |
|---|---|---|
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Note: These clearinghouses offer capabilities for electronic attachments. |
You may want to consult with your practice management software company to determine which clearinghouse, if any, their application works with.
Medical providers: If these clearinghouses are not an option for you, please call Provider Service at 1-800-882-2060 to check member eligibility and benefits.
Dental providers: If these clearinghouses are not an option for you, please call Dental Provider Services at 1-800-882-1178, option 3 for benefits and eligibility checks.
Please expect a longer than usual response time because of increased call volume from the event at Change Healthcare.
Authorization Manager is not impacted by the event at Change Healthcare. You can submit referral requests through that tool.
Please note it does not accept batch requests. Referrals must be submitted individually.
If you are unfamiliar with Authorization Manager, or need other support with the tool, please email: HMMAuthorizationManager@bcbsma.com.
Carelon
Our vendor, Carelon Medical Benefits Management, administers prior authorization programs for the services listed below. Carelon is not affected by the event at Change Healthcare. Please continue to use Carelon’s secure website to submit prior authorization requests for these services.
Other options
If the options above are unavailable to you, you can call or fax requests for an authorization using the numbers listed below. Please understand that respond times may be longer than normal.
| Commercial members |
Call 1-800-327-6716 Fax 1-888-282-0780 |
|
Medicare HMO and PPO members |
Call 1-800-222-7620 Fax 1-800-447-2994 |
|
Federal Employee Program (FEP) Contact your local plan. In Massachusetts, call |
Call 1-800-689-7219 Fax 1-888–282–1315 |
| Behavioral or mental health |
Call 1-800-524-4010 Fax 1-888-641-5199 |
| For acute levels of care | Fax 1-888-973-0727 |
Participate with MassHealth? (Sharing office hours)
We urge hospitals, medical groups and individual providers who care for MassHealth patients to attend one of the upcoming webinars that MassHealth is offering about alternative claim submission options and providers who may require financial assistance.
Check the Mass Health office hours registration website for the most current training dates.
Options to be presented:
Thank you for the care you provide to our members.