03/06/2024
BEACON PODIATRIC BILLING CLIENTS!!!
Beacon Podiatric Billing Services is aware of the recent cyberattack on Change Healthcare that occurred on February 20, 2024. https://www.nytimes.com/2024/03/05/health/cyberattack-healthcare-cash.html. We are closely following the information provided by our clearinghouse partners Trizetto, Availity, and Waystar for the variety of EHRs that service our clients.
Beacon is monitoring our client’s claims submissions and rejections, and will be resubmitting claims as soon as possible. We will also be following up on payer websites to verify receipt of these resubmitted claims.
This cyber attack is affecting all providers across the country to varying degrees, as some regional payers use Change Healthcare’s reciprocal agreements more than others. A reciprocal agreement is when one clearinghouse (Clearinghouse A) holds an exclusive contract with a payer (Payer A) , and all claims for “Payer A” must go through “Clearinghouse A”. No Other clearinghouse can submit claims directly to “Payer A”. In order for “All other Clearinghouses to get claims to “Payer A”, they make a reciprocal agreement with “Clearinghouse A” to route claims to “Payer A”. Each clearinghouse that has exclusive contracts with payers make these reciprocal agreements with the other clearinghouses so that all claims can be submitted electronically to all payers. A specific example is that Change Healthcare has an exclusive contract with Care Oregon. Trizetto, Availity and Waystar each have a reciprocal agreement with Change Healthcare so that any provider submitting claims to Care Oregon can use any of these clearinghouses to submit Care Oregon claims.
The Claims affected are being rejected by the above clearinghouses with a message similar to this “the route to this payer has been impacted by the Change Healthcare cyber incident. Providers will need to submit by paper, hold or utilize the payer’s DDE”.
As a work around, clearinghouses are trying to establish new connections to reroute claims other than through Change Healthcare to get to their destination payer. Once a new connection is established, we will be notified and will immediately resubmit claims.
Another temporary work around that was suggested was to print claims to paper and mail them to the insurance company. Some associations, however, have advised providers against that work around, as the insurance companies are not likely prepared to handle this volume of manual processing and it will cause further problems and delays.
Yet another solution suggested is to manually key claims on payer websites (where this is an option since not all payers have this ability). However, this will mean more hours of manual labor for the providers office. The only other choice is to hold claims until the issue is resolved.
Again, Beacon is committed to staying on top of this challenge for you and we will be keeping you apprised of any updates.
The hacking shut down the nation’s biggest health care payment system, causing financial chaos that affected a broad spectrum ranging from large hospitals to single-doctor practices.
