Change Healthcare Update: A Path Forward
As we navigate through the challenges presented by the ongoing service outage, we want to provide a Change Healthcare update to our valued clients regarding the latest progress towards system restoration. The clearinghouse team is dedicated to resolving this issue swiftly and efficiently. Here’s a comprehensive update on the progress made and what healthcare providers, pharmacists, and payers can expect in the coming days.
CHANGE HEALTHCARE UPDATE 4-23-2024:
Change Healthcare has finally confirmed that it paid a $22M ransom to BlackCat last month to regain access to its encrypted data, and acknowledged that some PHI/PII was leaked to the dark web (in the form of screenshots) and more of this data may be at risk of exposure or sale.
UPDATE 4-10-2024:
Please note that some clients are seeing two specific claims rejections after being set up to submit again:
- L2 PAYER ID IS UNSUPPORTED – meaning that the clearinghouse has not yet re-established a connection with that payer
- L2 PAYER ID IS EXPIRED – meaning that the payer ID may have changed; you can check here for the current payer ID lists [Exchange Payer List for claims submission, and Real-Time Payer List for eligibility verification] in Excel format: https://support.changehealthcare.com/customer-resources/payer-lists?abc
UPDATE 4-4-2024:
Optum held a webinar yesterday to discuss the restoration progress and plan for its Revenue Performance Advisor (RPA), which can be summarized as follows:
- Phase A: Initiates on Friday, April 5th, focusing on direct claims submission through the RPA interface for manual or batch processing. This phase is further broken down as follows:
- Initial connection for some users on April 5th.
- Additional set of users will be connected on April 9th.
- A third wave of users will be connected on April 11th.
- Phase B: Set to start the week of April 15th, this phase targets bulk claim submissions via SFTP, necessitating new credentials and setups through Optum’s Enterprise Communication Gateway. The plan includes reconnecting all existing customers over a three-week period starting from this date.
- Phase C and Phase D are planned but without specific start dates. Phase C will deal with real-time transactions like eligibility checks and claim statuses. Phase D will focus on electronic remittance advice (ERAs) and related functionalities, which may require re-enrollment with payers.
You can read the full PDF transcription here or view/listen below (nothing was shared on-screen, it is audio only):
A new Optum form for RPA SFTP setup is available at https://app.smartsheet.com/b/form/39ae10c671e149a1968476bc0275c855.
UPDATE 4-1-2024:
Optum held a call/webinar on Wednesday, April 3rd at 3 PM Eastern to provide the latest updates regarding progress on Revenue Performance Advisor (RPA) service restoration and answer questions.
UPDATE 3-26-2024:
Optum has sent E-mail notices regarding “preparing for Exchange Clearinghouse connection.” They plan to reconnect submitters to the Exchange clearinghouse to facilitate electronic claims submission and link to a form that clients should fill out in order to facilitate this process and be contacted by Optum. For directions on how to fill out the required fields, download this PDF and/or watch this video:
Please note: You are only required to fill out fields marked with an asterisk.
Restoration Efforts: A Glimpse into the Timeline
Change Healthcare has been working diligently to address the outage, with a clear focus on restoring functionality across their services. The timeline for these restorations marks a significant stride towards normalization:
- Pharmacy Services: A crucial update for pharmacies and patients alike, electronic prescribing capabilities have been fully restored. This includes functionalities for claim submission and payment transmission, ensuring patients continue to access their medications without interruption. Specifically, Optum Rx pharmacies have implemented measures to ship medications directly to members based on their next needed date, ensuring continuity in patient care.
- Payments Platform: Looking ahead, Change Healthcare has set March 15 as the target date for reactivating their electronic payments platform. This restoration is key for facilitating seamless financial transactions within the healthcare ecosystem.
- Medical Claims: The process of testing and reestablishing connectivity to the claims network and software is expected to kick off by March 18. The aim is to gradually restore service over that week, a move that will be welcomed by healthcare providers reliant on these systems for claim processing.
Adaptive Measures: Navigating the Interim
In light of the ongoing efforts to restore full service functionality, Change Healthcare recommends that providers and payers employ certain workarounds. One such adaptive measure is the utilization of the new iEDI claim submission system. This system serves as a redundancy measure, ensuring that claims processing can continue with minimal disruption amidst the current situation. If you’re interested in knowing more about iEDI claim submission, please email client_assistance@optum.com.
Optum has also implemented a Temporary Funding Assistance Program to “help bridge the gap in short-term cash flow needs for providers impacted by the disruption of Change Healthcare’s services.” You can learn more here.
For healthcare providers, pharmacists, and payers, these updates offer a beacon of progress in navigating the challenges posed by the service disruption. As we continue to monitor the situation, staying informed on these updates is crucial. Stay tuned for further updates as we follow the restoration journey together.