Advance and Accelerated Payment Program Available for Providers Impacted by the Change Healthcare/Optum Payment Disruption

Part A and Part B Providers experiencing cash flow problems related to Change Healthcare/Optum Payment Disruption (CHOPD), which began on 2/21/2024, may be eligible for Accelerated/Advance Payments (AAP). Accelerated and Advance Payments are intended to provide necessary funds to Part A and B providers, respectively, when there is a disruption in Medicare claims submission and/or claims processing. The expansion of the AAP is only for the duration of the claims processing disruptions associated with this incident.

As a result of the Change Healthcare/Optum Payment Disruption, most providers supported by this vendor are eligible to request up to 100% of the Medicare payment amount for a 30-day period. Requests must be submitted on the National Government Services Request for Accelerated/Advance Payment Form. 

At this time, Periodic Interim Payment (PIP) providers are not eligible to receive CHOPD accelerated payments. CMS will monitor the Incident closely and will determine whether these payment policies need to be modified as circumstances warrant.

Please review the Change Healthcare/Optum Payment Disruption (CHOPD) Accelerated Payments to Part A Providers and Advance Payments to Part B Suppliers Fact Sheet for detailed information on the CHOPD AAP.

Part A Accelerated Payment Steps

1. Providers must submit their request in writing using the form on our website.
2. These requests must be signed by the provider’s authorized official that is legally able to make financial commitments and assume financial obligations on behalf of the provider. (Digital signatures and fax requests are acceptable). 
   • Providers that are part of a group practice may attach a list of Provider Transaction Access Numbers/National Provider Identifiers (PTANs/NPIs) to the form. The authorized representative must have authority to sign on behalf of all parties included in the list. Payment will be sent to each individual NPI. 
3. Submit the request by email to the applicable email address below:
   • Jurisdiction 6 Part A/HH+H: J6AcceleratedPaymentPartA@anthem.com
   • Jurisdiction K Part A/HH+H: JKAcceleratedPaymentPartA@anthem.com  
     • The email addresses above are for new submissions only. Questions and/or status checks will not be accepted. 
4. Once our review is complete, we will send a decision letter to the provider requesting accelerated payment using the most expeditious method (e.g., email, facsimile, telephone). As a last resort, we may have to mail a copy of the decision letter. 
   • If the request is approved, the accelerated payments will be processed within five calendar days. Note that National Government Services (NGS) will issue electronic funds transfer (EFT) payments and standard financial institution processing times should be expected for the payment to reach your bank account.

Part B Advance Payment Steps

1. Providers must submit their request in writing using the form on our website (one for each billing PTAN).
2. These requests must be signed by the provider’s authorized official that is legally able to make financial commitments and assume financial obligations on behalf of the provider/supplier. (Digital signatures and fax requests are acceptable). 
   • Providers that are part of a group practice may attach a list of PTANs/NPIs to the form. The authorized representative must have authority to sign on behalf of all parties included in the list. Payment will be sent to each individual NPI. 
3. Submit the request by email to the applicable email address below:
   • Jurisdiction 6 Part B: J6AdvancePaymentPartB@anthem.com
   • Jurisdiction K Part B: JKAdvancePaymentPartB@anthem.com 
     • The email addresses above are for new submissions only. Questions and/or status checks will not be accepted. 
4. Once our review is complete, we will send decision letters to the providers requesting advance payments using the most expeditious method (e.g., email, facsimile, telephone). As a last resort, we may have to mail a copy of the decision letter.
   • If the request is approved, the advance payments will be issued within five calendar days. Note that NGS will issue EFT payments and standard financial institution processing times should be expected for the payment to reach your bank account.

Repayment Terms

Repayment will start immediately through 100% recoupment of Medicare claims payments owed to the provider, as claims are submitted and processed, after the date on which the payment is granted. Recoupment will continue for a period of 90 days.

A demand will be issued for any remaining balance on day 91 following the issuance of the accelerated and advance payment.

Interest will start to accrue 30 days after a demand is issued consistent with the interest rate established under applicable interest authorities. Any resulting demand does not convey administrative or judicial appeal rights, or rebuttal rights.

Note that repayment terms related to CHOPD Advance/Accelerated Payments are subject to change. 

Additional Information

NGS will provide updates to you. We encourage you to check our website and Events page for the latest updates. We will post information and schedule sessions to assist you through this process.

posted 3/11/2024