prism and pharmacy claims impacted by Change Healthcare major incident

What you need to know

Change Healthcare (IQ) has experienced a major incident affecting access to the InterQual tool, causing impacts to prism and other systems as of Feb. 21. Currently, there is no evidence that our member information has been impacted.

Impacts to prism and pharmacy claims

Some features in prism such as remittance and EOB, invoices, InterQual and Cost Estimator (Health Care Blue Book) are temporarily unavailable.

This incident has also impacted claims processing at network pharmacies. Pharmacies and members will experience issues with claims processing at the point of sale. Change Healthcare is continuing to address the claims processing interruption.

Pharmacies can try to submit claims later today. Patients can get a partial fill or pay out-of-pocket and submit for reimbursement.


Guiding Care is available and submissions can still be submitted via prism. Providers may experience intermittent access issues as we progress through this issue. Please continue to check any alerts in prism for updates.

Thank you for your patience as we work to validate all systems and return to full operations.