Change Healthcare, Inovalon ABILITY Network FAQs
If I do not have access to the Inovalon ABILITY Network, how do I submit claims?
Please inform your clearinghouse that the Benefit Funds now use the Inovalon ABILITY Network. Your clearinghouse should be able to establish a connection to route claims there.
If I receive confirmation from a non-Inovalon ABILITY Network clearinghouse that it has received my claims, have the Benefit Funds also received my claims?
If you are using a clearinghouse other than the Inovalon ABILITY Network, your claims will still reach the Benefit Funds, although submission and processing times may vary. After the Benefit Funds receive the claims, the Inovalon ABILITY Network will send you a second confirmation.
Should I consider submitting claims as paper copies via mail instead of electronically?
Please submit your claims electronically; this will allow you to be reimbursed faster. Clean claims that are submitted electronically are typically processed within seven days of receipt, while paper claims can take up to 45 days to be processed. Due to the Change Healthcare cybersecurity incident and outage, please allow additional time for the processing and payment of claims.
Will timely filing be honored for all claims?
The Benefit Funds will honor claims submitted within 365 days from the date of service or discharge. Aetna Choice POS II contracted providers have 120 days from the date of service or discharge to submit claims.
How long will it take to switch to the Inovalon ABILITY Network?
The process may take up to two weeks.
Why have I not received rejection reports when I have submitted claims?
You may have received a 999 acknowledgement of receipt from your intermediary clearinghouse. If your clearinghouse is not in the Inovalon ABILITY Network, you can expect delays receiving rejection reports.
Has the process to submit a request for authorization changed since the Change Healthcare outage?
No, the process has not changed. To submit a request for authorization, please visit www.1199SEIUBenefits.org/providers/prior-authorization/ for information and instructions for different vendors.
Has the process to check authorization status changed since the Change Healthcare outage?
No, the process has not changed. Please continue to reach out to the corresponding prior authorization program administrator.
Has the process to check eligibility, benefits and/or claims status changed since the Change Healthcare outage?
No, the process has not changed. You can check eligibility, benefits and/or claim status through our existing processes. To check the status of a claim, please visit our Provider Portal at www.NaviNet.net. For NaviNet Customer Support, including registration and technical assistance, please call NaviNet at (888) 482-8057. You can also call our Interactive Voice Response system at (888) 819-1199, or call (646) 473-7160 to speak with a representative if you have more detailed inquiries.
Will an extension be granted for claims reconsideration?
You have 180 days from the date of the Benefit Funds’ date of denial or payment to submit a claim reconsideration.
Inovalon ABILITY Network:
Client Services – (301) 809-4000
[email protected]
Payer ID – 13162
Receiver ID – 223389595
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