TherapyNotes Update Regarding Change Healthcare--3/19/24

  TherapyNotes posted an update on their blog this evening regarding the Change Healthcare outage....and it's NOT good. I will first provide a summary and my opinion...and then paste their blog.  So make sure you read to the end!!

  SUMMARY: 

• Change Healthcare will NOT be coming online any time soon for TherapyNotes Users
  

• Per Change's recommendation, TherapyNotes is transitioning to use Optum's IEDI clearinghouse and will send commercial claims that do not require pre-enrollment that are in the queue in TherapyNotes as Pending.
  

• For payers that require pre-enrollment, Change is working with those payers to allow dual enrollments (Change and Optum iEDI) so providers do not have to re-enroll BUT there is no timetable when this would be active.
  

• TherapyNotes has decided for the long term to switch away from Change Healthcare to another clearinghouse (Trizetto?  ClaimMD?).  When this happens, providers will have to re-enroll with all payers that require claim enrollment AND re-enroll for ERAs.  This could take up to 6 weeks (usually up to 2-3 weeks for claim approvals, up to 6 weeks for ERA approvals).
  

• They said they will be offering multiple clearinghouse support so I'm not sure if once Change Healthcare comes back online if you can still submit ongoing via Change so you don't have to re-enroll with payers!  That is an important consideration.
  

• For now, my recommendation is we continue to submit via OfficeAlly for those providers for whom we are submitting via OfficeAlly.  Even for some of these providers we have not enrolled for electronic claims due to the time frame involved.  If by the end of this week TherapyNotes does not have more info about Optum's iEDI and if providers have to re-enroll for claims, we at that time will probably enroll the OfficeAlly users for enrollment with select payers.
  

• If more info is not forthcoming by the end of this week, we also will have to re-enroll providers for ERAs to be sent to another clearinghouse.  All along we had been told that ERAS would continue to be sent to Change Healthcare during this outage, but we are not sure if that is correct.
  

Here's their blog from this evening:

"Optum previously reported that they would begin turning on and rolling out Change Healthcare services through this week - the week of 3/18. We expected we would be fully operational by the end of the week. However, as they described the rollout schedule of the various services, and how we fit into that schedule, we realized that we may still be a couple weeks away from being able to resume services, which of course is entirely unacceptable.

Over the past several weeks we have been preparing to support alternate clearinghouses, in the case Change Healthcare could not restore services in a timely manner, and we are now ready to start sending claims through another clearinghouse.

We have been working with Optum and their iEDI clearinghouse as a means to send claims, and this afternoon we sent a few test claims. We are now waiting for confirmation from the payer that these were received successfully. We will continue to send out claims tomorrow, and as we gain confidence everything is working, we will start sending out all queued up claims for payers that don't require enrollment, with the goal of having them all sent by the end of the week.

We will not be sending claims to payers that require enrollment to iEDI in this first round. Optum is working with payers, such as government and BCBS, to support dual enrollment so you don’t need to reenroll. As Optum gives us the go-ahead we will send claims for these additional payers.

All that being said, we have made the decision to switch to a new clearinghouse, something we have been preparing for from the beginning. Because we haven’t signed the final agreements yet, we can’t announce who it is, but we have been impressed with their services. We have confidence we can switch quickly and we will share a more specific timeline when we are able.

The primary benefit of the new clearinghouse over iEDI is that we will be able to send claims to the payers that require enrollment. Unfortunately, practices will need to re-enroll with all payers to send claims, but we are going to provide a streamlined process.

Of course if Change Healthcare comes back online before this work is done, we can make the decision to send claims out for these payers. Yes, it’s hard to keep up with all these moving parts and possible paths, but because our software now supports multiple clearinghouses we have more flexibility to make decisions as we get more information.

The Mark External Claims page will continue to show the claim file download button for any claims that we aren’t sending, so you will be able to focus on the claims for payers that require enrollment. Alternatively, you can continue to wait for Change Healthcare or the new clearinghouse to be ready, whichever comes first.

Unless you changed anything, regardless of how we send the claims, your ERAs are still going to go to Change Healthcare. This means you won’t be able to receive them until Change restores service. When the new clearinghouse is ready we will work with you to update payer enrollments to send your ERAs there instead. We will be updating our software to receive ERAs from both clearinghouses."

Thanks,
Steve