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Navigating Medicaid Verification Challenges During the Change Healthcare Outage

In our line of work, challenges can arise unexpectedly, and how we navigate through them truly defines our commitment to serving our clients. Currently, many of us are facing difficulties verifying Medicaid eligibility online for Dual Eligible Special Needs Plan (D-SNP) clients. If you’ve encountered this issue, rest assured, you’re not alone. Let’s delve into what’s happening and how we can adapt to ensure continued quality service for our dual-eligible clients during this time.

Understanding the Issue: Why are Medicaid Verification Tools Down?

Several national carriers, including Aetna, Anthem, Humana, Wellcare, and UnitedHealthcare, rely on a third-party health technology vendor, Change Healthcare, for Medicaid eligibility verification. Unfortunately, Change Healthcare recently experienced a cyberattack, leading to the shutdown of parts of its electronic system. Consequently, carriers partnered with Change Healthcare have lost access to crucial data required for Medicaid verification.

Read more about this outage here.

Finding Solutions: Workarounds During the Outage

In response to this outage, affected D-SNP carriers have communicated alternative methods for Medicaid verification to agents. We recommend checking your email for these communications, which may include specific instructions and process changes for handling D-SNP enrollments during this period. We also encourage you to contact carriers’ Broker Support Departments for assistance. Additionally, be prepared to submit verification documentation, such as the applicant’s state-issued Medicaid award letter and card, along with D-SNP enrollments. If you have questions, please reach out to us.

Looking Ahead: When Will Online Verification Tools Be Operational Again?

As per the latest information available, the outage is anticipated to last another one to two weeks. While this may present challenges in the short term, it’s essential to remain proactive and adaptable in your approach.

Closing Thoughts: Support Through Challenges

We understand the inconvenience posed by the disruption of online Medicaid verification tools. However, as a dedicated Medicare sales FMO, we are committed to overcoming these challenges and ensuring the best possible outcomes for our agents and your clients. Remember, we here at NCC are available, and together, we can navigate through this period with resilience and determination.

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