Industry Alert: Navigating Recent Change Healthcare Cyber Attack
UPDATED MARCH 27, 2024
We’ve been sending updates regularly to the Primary Contacts for both BreezyBilling and BreezyNotes customers. Here is the latest general update as we continue to work through the complexities of rerouting claims and ERA.
Update on Claims for BreezyNotes Users
Currently the only claims we can't get around Change Healthcare are Cigna Behavioral Health. All other claims are going through at this time and we are continuing to look for a workaround. We got all other claims rerouted and submitted through our clearinghouse last week.
Update on Payments (Direct Deposit/EFT) for BreezyNotes Users
We have heard reports of providers starting to receive payments from some of those earlier submitted claims. Hopefully the payments start catching up for everyone.
Update on ERAs for BreezyNotes Users
We are still missing quite a few payers' ERA. Payments on ERA run on separate, but parallel, tracks. Our first focus was getting claims to the payers so you could get paid. With that primary goal nearly completed, we switched focus to getting ERAs back from the payers so can post them in BreezyNotes.
In this first run, we are starting with our two largest affected payers, Ucare and HealthPartners, and moving on from there. For BreezyNotes customers not using our billing services, you may need to complete a separate enrollment step within the Ucare Provider Portal. If that's the case we will make sure to send instructions.
Why No ERA Even if You're Getting Payments (including an example)?
When you send a claim to a payer they process it and then respond with two routes back:
An Electronic Funds Transfer (EFT), which simply means they transfer funds from their bank account directly into your bank account (hence "direct deposit").
An ERA file sent to your clearinghouse explaining how to divvy up that payment.
EFT payments and ERA run on separate, but parallel tracks. Change Healthcare routes claims and ERA between provider and payer, but not EFT.
A simplified "Normal Times" Example:
You send a claim for $200 to United Healthcare (UHC). That claim is "routed" from BreezyNotes to Inovalon (our clearinghouse) to Change Healthcare (an 'intermediary' clearinghouse) and finally to UHC (the Payer).
UHC processes the claim and agrees to pay $150 and adjusts off $50 per your contract and the client's coverage.
UHC then initiates an EFT to transfer $150 from their bank account to your bank account.
At the same time UHC initiates an ERA to go back through Change Healthcare, then Inovalon where your Breezy biller posts the ERA into BreezyNotes, which results in a $150 payment and $50 adjustment applied to your client's account.
When Change Healthcare went down, it broke Step 1 and Step 4 for roughly one third of the claims/ERA in our country. We got Step 1 fixed last week, which means Steps 2 & 3 are starting to work, too, despite an understandably significant backlog. Now we are working on Step 4. To complicate matters, there is often more than one intermediary involved!
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POSTED MARCH 6, 2024
In light of the cyberattack on Change Healthcare, we're sharing important updates and reassurances regarding the continuity and security of our services at BreezyBilling.
A Brief Overview of the Situation
Change Healthcare is a clearinghouse and revenue cycle management technology company owned by Optum. Change Healthcare is a direct or downstream intermediary for many varied healthcare companies across the United States. Before the outage, a large swath of America’s digital healthcare claims were being processed or passed through Change Healthcare.
On February 21, Change Healthcare experienced a security breach when a ransomware group named Blackcat exploited a vulnerability in ConnectWise ScreenConnect, a commonly used remote desktop support software. In response, Optum and Change Healthcare immediately halted and secured all impacted areas of their organization within their control.
The most recent update, according to Healthcare Finance News, is that Optum (specifically its United Health Group (UHG) unit) paid a $22 million ransom in bitcoin, although there is not an official update from UHG at this time.
UHG has significantly updated its status page with Q&A about claims, payment, and remittance processing as well as a fund established to help affected providers.
We urge everyone to review the information provided on the UHG Status Page.
Is BreezyBilling Affected?
BreezyBilling is not affected by the ConnectWise vulnerability. We understand the concerns this situation may raise about your own operations and the security of your data. Our IT team has diligently confirmed that both our internal systems and our vendors' systems are secure, ensuring that our operations continue without interruption.
Our Commitment to Service Continuity
We recognize the impact that this disruption may have on you, your staff, and your clients. Delays in processing claims can be challenging, but please rest assured that addressing this issue is our top priority.
Our own clearinghouse has been working through the complex process of rerouting claims and ERA. As of this post, the vast majority of claims have been rerouted with the exception of one major MN payer.
We are currently looking into setting up alternate routes for claim submission.
If you currently have Electronic Funds Transfer (aka EFT or ACH) payments set up with your contracted payers, and we can get your claims routed, you should expect to get paid.
Concurrently with getting claims routed, we are working to get Electronic Remittance Advice (ERA) routes established as well. ERA is the computer-readable file that BreezyNotes and other Practice Management softwares process that has all the claim payment information including how much was paid, to whom, what adjustments were made and denial reasons. Without ERA, providers get paid, but they don’t know remaining balances on client accounts or how to divvy it up among staff.
For other practice management and EHR softwares that we support, you will need to work the support teams directly for alternative options. Our billing team is actively reviewing and modifying our RCM processes in order to accommodate these changes.
We're Here for You
We know these are challenging times, but we're committed to navigating through them together. If you have any questions or need further clarification, please don't hesitate to reach out by replying to this email.
Thank you for your continued trust in Breezy. Together, we will overcome these obstacles and continue to deliver the exceptional service you've come to expect from us. If you know other mental health practices in need of direct guidance, feel free to send them our way.
