How to Confirm D-SNP & Medicaid Eligibility During the Change Healthcare Outage

Running into problems verifying Medicaid eligibility online for Dual Eligible Special Needs Plan clients? You’re not alone.

Here’s what you need to know to continue providing quality service to dual eligibles at this time.

Why Are Carriers’ Medicaid Verification Tools Not Working?

If you sell D-SNPs, you’re likely already aware that online Medicaid verification tools are not working within some carriers’ agent portals.

Many national carriers, including Aetna, Anthem, Humana, Wellcare, and UnitedHealthcare, work with a large third-party health care technology vendor, Change Healthcare, to verify Medicaid eligibility. On February 20, Change Healthcare experienced a cyberattack, forcing the company to shut down parts of its electronic system. As a result, carriers partnered with Change Healthcare no longer have access to the data they need to verify Medicaid eligibility.

Read more about other implications of the Change Healthcare outage

Workarounds for Verifying Medicaid Eligibility During the Change Healthcare Outage

All affected D-SNP carriers that Ritter partners with have sent out communications on alternative methods of Medicaid verification for agents to use until services are back online. We recommend that agents check their email for this communication from carriers, as it may also include additional carrier-specific process changes for handling D-SNP enrollments.

Generally speaking, agents should contact carriers’ Broker Support Departments for assistance with Medicaid verification during this time. You can find this contact information on our Ritter Docs carrier pages. Additionally, be prepared to submit verification documentation, such as a copy of the applicant’s state-issued Medicaid award letter and a copy of their Medicaid card, along with D-SNP enrollments.

Will Online Medicaid Verification Tools Be Up & Running Soon?

We’ve heard that the outage is expected to last another one to two weeks.

We understand the disruption in access to online Medicaid verification tools is inconvenient and makes D-SNP enrollments a little more challenging for agents for the time being, but know we are here to help you continue to enroll and best serve your clients.

Have additional questions? Please contact your Ritter sales specialist.