Change Healthcare Outage FAQ Update

IU Health Plans continues to navigate the impacts of the Change Healthcare outage and strives to provide the most up-to-date information to our provider partners. In adhering to this standard, we've updated our FAQ and encourage you to review it. Important updates include information on Medicare Advantage (MA) EFT/ERA distribution, MA ERA/835 registration, timely filing and interest payments on delayed MA EFT payments. Please check back regularly for future updates on our website home page banner and the provider resources page, section 4.

Updated Change Healthcare Outage FAQ

If you have any questions or concerns, please contact Provider Services, Mon. - Fri. from 7 am - 7 pm at the following numbers:

Commercial provider line: 866.895.5980
Medicare Advantage provider line: 866.218.1524

Change Healthcare Outage FAQ Update

IU Health Plans continues to navigate the impacts of the Change Healthcare outage and strives to provide the most up-to-date information to our provider partners. In adhering to this standard, we've updated our FAQ and encourage you to review it. Important updates include information on Medicare Advantage (MA) EFT/ERA distribution, MA ERA/835 registration, timely filing and interest payments on delayed MA EFT payments. Please check back regularly for future updates on our website home page banner and the provider resources page, section 4.

Updated Change Healthcare Outage FAQ

If you have any questions or concerns, please contact Provider Services, Mon. - Fri. from 7 am - 7 pm at the following numbers:

Commercial provider line: 866.895.5980
Medicare Advantage provider line: 866.218.1524

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Prescription Drug Transition Policy

For Non-Long-Term Care Residents

For any drug that you are currently taking that is not on our formulary, or that requires additional authorization, we will cover a temporary 30‐day supply (unless you have a prescription written for fewer days, in which case multiple fills will be allowed to provide up to a total of a month’s supply of medication) when you fill the prescription at a network pharmacy. If you are given this temporary supply, please speak to your doctor before you use the entire supply so you and your doctor can select a formulary alternative or request an exception. We will not pay for this drug beyond your first 30‐day supply unless you have been approved for a formulary exception.  

For Long-Term Care Residents

If you are a resident of a long‐term care facility, we will cover a temporary transition supply up to 31 days.  If you need a drug that is not on our formulary, or is subject to additional authorization, but you are past the first 90 days of membership in our plan, we will cover up to a 31‐day emergency supply of that drug (unless you have a prescription for fewer days, in which case multiple fills will be allowed to provide up to total of a month’s supply of medication) while you pursue a formulary exception or work with your physician to select a formulary alternative.  

For Members Moving from Home to a Long-Term Care Facility or From a Long-Term Care Facility to Home

If your level of care changes (e.g., entering a long term‐care facility or going home after a stay in a long‐term care facility), Indiana University Health Plans provides transitional supplies of non‐formulary or otherwise restricted medications. For the first month after being discharged from a long‐term care facility, you can get at least a 31‐day supply of your current medications to allow time for you and your physician to switch to a formulary alternative or request an exception. 

Indiana University Health Plans is a Medicare Advantage organization with a Medicare contract. Enrollment in Indiana University Health Plans depends on contract renewal. Other pharmacies/physicians/providers are available in our network. Product types include HMO and HMO-POS. H7220_IUHMA19511 Accepted 11/17/2018