Greetings Doctors, Therapists & Staff,
I hope by now that you are aware of the ransomware attack that Change Healthcare experienced last month. I’ve been monitoring the dozen, or so, healthcare news feeds I follow to keep track of the massive damage caused by this cyberattack, as well as any impending fixes on the horizon of which there hasn’t been much shared on that front. If you haven’t kept up with this story I’ll provide a brief recap.
In the wake of the February 2024 Blackcat ransomware attack on UnitedHealth Group-owned [UHC] Change Healthcare, the Department of Health and Human Services (HHS) has issued a stern warning to healthcare providers nationwide. The cyberattack, which incapacitated over 100 of Change Healthcare’s systems, has sent shockwaves through the industry, leaving providers scrambling to cope with severe cash flow problems.
Providers relying on Change Healthcare’s systems for crucial tasks like insurance coverage verification, claims submission, and payment processing have found themselves in dire straits. The fallout has prompted several industry groups to petition the HHS for assistance, citing the crippling impact on their members’ financial stability. According to recent statistics 94% of hospitals are experiencing a financial impact, and healthcare providers, in general, may be losing up to $100 million a day from the cyberattack.
UnitedHealth Group’s temporary financial assistance program has drawn criticism for its limited eligibility criteria and burdensome terms, exacerbating frustrations among affected providers. The HHS, while acknowledging the gravity of the situation, has emphasized the need for concerted efforts to minimize disruptions to patient care.
In response to mounting pressure, the HHS has rolled out a series of flexibilities aimed at alleviating the strain on healthcare providers. These measures include expedited processes for changing clearinghouses, relaxation of prior authorization requirements, and encouragement for payers to offer advance funding to affected providers.
Providers grappling with claims processing challenges are urged to reach out to their Medicare Administrative Contractor (MAC) for support. The CMS has instructed MACs to fast-track new electronic data interchange (EDI) enrollments and accept paper submissions if necessary.
Despite these efforts, concerns linger that the new flexibilities may fall short of addressing the full extent of providers’ financial woes.
The cyberattack on Change Healthcare serves as a stark reminder of the critical need to bolster cybersecurity resilience across the healthcare ecosystem. The HHS has reaffirmed its commitment to enhancing cybersecurity measures, urging stakeholders to prioritize cybersecurity with renewed urgency.
Providers are advised to stay vigilant and proactive in safeguarding patient data and financial stability. It is imperative that providers check with their clearinghouses to ascertain how they are addressing the aftermath of the cyberattack and safeguarding patients’ protected health information (PHI).
As the healthcare industry navigates the fallout from this cyberattack, the resilience and collaboration of providers, industry stakeholders, and government agencies will be crucial in mitigating the impact and ensuring the continuity of care for patients nationwide.
All that said, a couple more notes of importance here. For our clients, we continue to monitor for any denials via electronic submissions that are directly related to this cyberattack. Please be aware that many clearinghouses must funnel claims through Change Healthcare to reach the desired insurance carrier. This is one of the reasons why so many entities were against UHC being able to purchase Change Healthcare. It has created a near monopoly of sorts as UHC owns so many insurance entities [ie Optum, UMR, etc], or have very “interesting” ties to other insurers where deals are made that require e-claims to arrive via Change Healthcare. So, your clearinghouse may have to funnel certain claims to another clearinghouse [Change Healthcare] before it finds itself at the final insurer destination. These ties have potentially compromised those clearinghouses unrelated to Change Healthcare because of the cyberattack threat.
If you have recently noticed batches of e-claims denied, since February or early March, for reasons you’ve never experienced before it’s a good bet the Change Healthcare incident is behind it. In some cases we’ve been able to re-route the claims if our clients’ clearinghouse has already effected such a fix; in other cases, we may have to switch these e-claims to printed claims and mail them in. It’s a tedious and costly process as some insurance companies have continued to refuse paper claims regardless of the Change Healthcare matter, and even with HHS flashing warnings to insurers to allow for all methods of claims submissions until this is resolved. We also continue to get mixed messages from insurance companies when we call as sometimes we hear “go ahead and mail”, and sometimes we hear “don’t mail, they’ll just be trashed; give it time for the original problem to be fixed” – all this from the same insurance company!
We understand the financial stress this puts to all providers, but know we’re on it and will do what we can to get claims submitted as soon as possible. Know, too, we cannot repeatedly resubmit electronically through the same clearinghouse until the all-clear is issued. The claims will just continue to get denied or kicked out not to mention really anger the clearinghouse.
One critical proactive measure that each and every provider should take immediately is to place a call to your respective clearinghouse and ask them how they are affected by the Change Healthcare cyberattack; what are they doing to safeguard themselves and protect your patients’ PHI information; how can you get any of your denied e-claims submitted safely to the insurance carriers [have they developed a work-around]; when do they expect to be back at full e-claim submission capacity?
I hope this has helped to shed a little more light on what has been happening in the claims submission world due to this cyberattack, and how your claims may be affected now and in the near future. Use this opportunity as well to check on your own malware programs in your office and home systems.
Think you might require billing and collection services? Call us for a no obligation chat to discuss your needs, or any difficulties you may be experiencing with your insurance revenue management. We work and bill directly from your software, and our knowledge and experience in different software programs now exceeds more than a dozen programs! We also post your payments for you directly in your software! Mention you read this e-newsletter and we’ll waive your start-up fee!
***We are pleased to announce the EHR software we work out of has expanded and now includes the following: ChiroTouch, ACOM, PayDC, EZNotes, Eclipse, ChiroHD, Office Ally, ChiroFusion, zHealth, CollaborateMD, MediSoft, Jane App, and more! Don’t see yours on the list? We continue to expand every month! Call to find out more!
Yours in health and wealth,
Dr Art
Dr. Arthur I. LeVine
CEO & Founder, iCollect Medical Billing Services, LLC
Past President, Florida Chiropractic Assn.,
Board of Directors, Florida Chiropractic Assn.,
Chairman, Insurance Relations Committee, Florida Chiropractic Assn.,
Co-Chairman, Government Relations Committee, Florida Chiropractic Assn.,
Florida Representative, Congress of Chiropractic State Assns.,
7027 W. Broward Blvd., #229
Plantation, FL 33317
954-530-6232 Office
206-309-4925 Fax to Email
