Change Healthcare Nationwide System Outage May Affect Providers’ Claim Submissions

On February 21, 2024, Blue Cross and Blue Shield of North Carolina’s (Blue Cross NC) pharmacy benefit manager, Prime Therapeutics, alerted us of a nationwide system outage affecting the company, Change Healthcare (CHC).

We have since learned that the CHC outage has prevented some providers and hospitals using CHC as a vendor for their operations from being able to send claims electronically to insurance companies, including Blue Cross NC.

Providers affected by the CHC issue may choose from the following during any period that they are unable to send claims using CHC.

• Use a different vendor to electronically submit claims to Blue Cross NC
• Submit electronic claims directly to Blue Cross NC without using a clearinghouse
• Direct enter claims via Blue e, our secure provider portal
• Submit a paper claim. Information on how to submit paper claims can be found on the provider section of our webpage: https://www.bluecrossnc.com/providers/claims-appeals-inquiries

Blue Cross NC does not provide other services that CHC may provide for your organization (e.g. claims scrubbing or other value-added services). As a result, use of alternative filing methods could lead to a higher-than-normal error rate. All claims must be submitted in 837 format.

The CHC outage is also preventing eligibility and claim status inquiries for Brighton Health Plan Solutions members through Blue e. Please call Brighton Provider Services (877-606-6739) for benefit verification for members with the following prefixes during this time. 

• HFG
• HGI
• HWS
• HMF
• HZN
• XZW
• Y2H
• Z2E