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To continue supporting providers following the Change Healthcare cyberattack and to implement recommendations from the Department of Health Care Services (DHCS), CalOptima Health is temporarily extending its filing deadline for claims.
CalOptima Health and its health networks will allow an additional 90-day grace period to the existing 365-day timely filing deadline for provider claims received as of February 21, 2024, or later. This flexibility applies to both Medicare and Medi-Cal claims and will continue until such time as Change Healthcare remediates the effects of the incident.
This grace period is in line with a DHCS memo sent to all managed care plans (MCPs) on March 13, 2024, regarding Change Healthcare and MCPs’ legal obligation to pay all claims within contractually mandated statuary timeframes. DHCS also strongly encouraged MCPs to take the following steps:
- Accept paper claims
- Remove or relax timely claim filing requirements
- Remove or relax prior authorization or utilization management requirements
- Establish workarounds to continue paying claims
- Publish and update information on their websites
- Work with subcontractors, downstream subcontractors and network providers
Since February, CalOptima Health has notified providers on using Office Ally, its contracted electronic data interchange clearinghouse, as the preferred method to submit claims and how to submit hard-copy claims. Providers receiving physical checks have also been given instructions on how to receive electronic payments and check the status of their claims through the CalOptima Health Provider Portal.
CalOptima Health’s prior authorization process remains unchanged as the health plan does not use Change Healthcare for authorizations.
CalOptima Health is in close communication with Change Healthcare and monitoring developments carefully. Providers can find the most up-to-date information under the Provider section of our website, www.caloptima.org, or by visiting the Provider Portal. For additional questions, contact CalOptima Health’s Provider Relations department at 714-246-8600.
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