Update on Telehealth Claims Issues

Dear Provider Partners,

We want to acknowledge the concerns many of you have raised regarding recent World Trade Center (WTC) Health Program telehealth claims processing issue. We understand the uncertainty this has created and appreciate your patience as we work through the issue.

An administrative system change that was put in place on February 1, 2026, inadvertently impacted telehealth claims. The WTC Health Program did not intend to disrupt reimbursement or the processing of claims. Our team has been diligently taking steps to correct the system and impacted claims. As of May 29, 2026, the system issue that caused the problems with telehealth claims has been fixed and all newly filed telehealth claims should be processed as usual.

For previously denied claims:
Claims that were incorrectly denied during the affected time period have been reprocessed. If the claim was approved, payments should be dispersed to providers no later than June 12, 2026. Please note that some claims may continue to be denied for valid processing or coverage-related reasons unrelated to this issue. Any denials related to coverage requirements or processing issues will continue to follow the standard WTC Health Program review process.

For claim adjustments:
During the affected time period, some claims were approved and paid with the incorrect reimbursement rate. The WTC Health Program is processing claims adjustments which should be sent to providers no later than June 18, 2026.

We value our partnership with providers and recognize the critical role you play in delivering care to WTC Health Program members. Supporting a strong and reliable provider network remains a priority for the Program. We remain committed to maintaining a stable and supportive provider network and appreciate your continued care of Program members while we work to resolve this issue.

In addition to addressing affected claims, the WTC Health Program is reviewing this matter and implementing safeguards to help prevent similar issues from occurring in the future

If you have questions regarding your reimbursement or payment, please call 1-888-982-4748, or email wtchp_provider_enrollment@gdit.com for assistance.

To help ensure timely communication regarding future WTC Health Program updates, providers are encouraged to maintain current contact information, including an email address, with the Program. Once our review is complete, we will communicate the outcome and any necessary next steps.

Thank you for your continued partnership and for the care you provide to our members.

Sincerely,

RDML Lisa J. Delaney
Director, World Trade Center Health Program