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Provider Updates

Provider Updates for 2024 Change Healthcare Claims Outage

April 2, 2024

Our scheduled commercial and Medicare payment cycles will resume the week of April 7, 2024. Providers can expect to see consistent payments from Network Health.

Timely Filing and Interest Payment Waiver

Claim denials related to the 30-day timely filing extension will be reviewed upon request. Providers must notify their provider operations manager of any claim denials to be reviewed on or before May 1, 2024.

March 15, 2024

We have issued Commercial and Medicare payments for 2/26/24. You should be receiving payment within the next 3-5 business days. Additionally, we will be issuing Commercial and Medicare payments on 3/19/24 and 3/22/24.

March 11, 2024

In lieu of the national outage and the inability to submit electronic claims to Network Health, we have partnered with SmartData Solutions (SDS) and Availity to enable our provider partners to submit electronic claims to Network Health effective March 11, 2024. Both clearinghouses use our existing payer IDs:

Commercial: 39144

Medicare: 77076

SDS

If your current EDI trading partner works with SDS, please direct Network Health claims to SDS using our payer IDs. If your current EDI trading partner does not work with SDS, please create an account using these simple steps below.

  1. Click this link to SDS, then select the green box titled Provider Portal

  2. Click Register

  3. Fill out the required fields in the Account Confirmation Form

  4. Submit the request. Please note, if you select the option for verification code communication via phone, it will take one business day, fax verification will take one hour, and mail will take between three to seven business days. If you do not list your NPI on the Account Confirmation form, it will prolong the process. Your registration will be confirmed via email. 

  5. Once you receive your verification code, you need to finalize your account

  6. Finally, you need to create a password. Once submitted you will receive a login name and a link to login to SDS. Once again, your registration completion will be confirmed via email. 

  7. Once you have registered, please refer to the SDS Companion Guide to learn how to submit your first file. Attached is the claims submission guide to assist you. If you have questions regarding SDS, please contact them at [email protected] or 855-297-4436.

Availity

Availity has created a registration page for those affected by the Change Healthcare outage. If you are an existing Availity Essentials Pro customer, no action is needed. Essential Pro customers already have access to transact electronically with sponsoring health plans on the Availity network.

Please visit availity.com/availity-lifeline-self-serve-resources to start your registration and view training resources to submit electronic claims to Network Health.

Timely Filing and Interest Payment Waiver

Due to the unforeseen circumstances of this national outage, we will extend timely filing an additional 30 days, and apply interest payments after 60 days. We will re-evaluate if an additional extension is warranted after 30 days.

Real-time Eligibility

Our eligibility was managed by Change Healthcare and it is currently unavailable. We are looking at alternative solutions and will provide an update as soon as it is available.

Provider Payments and Remittance Advice

We are currently working with our vendor ECHO on restoring provider payments and remittance advice and will provide an update as soon as it is available.

If you have more questions, please contact your provider operations manager directly.


Network Health
1570 Midway Place
Menasha, WI 54952
Hours
Mon., Wed.-Fri.: 8 a.m. to 5 p.m.
Tuesday: 8 a.m. to 4 p.m.

COVID-19 Information for Network Health Members

Learn more about the recent Change Healthcare breach.