Back Up Plan Due to Change Healthcare Cyber Security Attack

     Some providers have contacted us asking what can be done for your claims due to the Change Healthcare Cyber Security Attack.  As of right now Change Healthcare has not provided any guidance as to when this issue will be resolved.  It could be days, it could be weeks or it could be months.

  However, we do know they are prioritizing getting their systems back online that pertain to patient care (such as e-prescribing and imaging).  After they take care of that they will then focus on restoring revenue cycle operations so claims can be submitted and ERAs downloaded.

  At the present time we are asking clients to be patient.  If no definite timeline is provided by Change later this week about when revenue cycle operations will be restored, we will offer a back-up plan.

  We understand that not being able to submit claims can affect your revenue stream.  Some providers understandably want claims going out every day/every week.

  If it is necessary to offer a back-up plan for submitting via another clearinghouse, here are a few things to keep in mind:

• Your office would be required to enroll for EDI Batch claims with the clearinghouse; the clearinghouse would charge you directly their monthly fees (depending upon the number of transactions you select).  For example, for 250 claims/ERAs per month the fee is $35 per month.

• There would be a one-time set-up fee we would have to charge our clients for configuring all payers in our software for the new clearinghouse.

• Some payers (such as Medicare and many BC BS payers) will require EDI Enrollment that can take anywhere from 1-6 weeks for approval.  The clearinghouse does have a Payer List available so you would be able to check if EDI Enrollment is required (EDI enrollment is always required for Medicare).

• There would be a higher per-claim fee that we would have to charge to submit via another clearinghouse.

Some providers have asked if we will submit via a payer's portal.  The answer is no....we will not manually submit any billing via a payer's portal as it is far too time consuming. 

For providers who are using TherapyNotes you could submit yourself via the payer portal OR you could print and mail the paper claims if you want. 

• Note, though, if you do submit via either of these methods you must change the status of that date of service to Submitted External or Submitted In Network Paper.

If your office does not want to wait until later in the week and wants us to convert to a back-up plan now, please contact me via email for information.  Note that should your office choose for a back-up plan claims cannot be submitted immediately.  Because of the enrollment work you must do and the set-up work we must do we do anticipate it taking a couple of days per practice.

Thanks for your understanding during these trying times.

Steve