TCCN Lead Physicians, Practice Administrators and Billing Managers,

What you Need to Know Now!

• This attack occurred on 2/21/24 and may affect your ability to file claims and to receive payments
• The attack affects many payors beyond United HealthCare
• Change Healthcare group is a subsidiary of United Health Group and Optum

The ransomware attack can affect you on three main fronts:

1.   This may be your practice’s claims clearinghouse; or

2.   Change HealthCare may be the electronic claims payment clearinghouse that a payor or TPA utilizes to make their payments to you by connecting with your clearing house; and

3.   This disruption can interfere with your ability to gather information for enrollment verification and prior authorizations; and

• While your clearinghouse may be Waystar, Availity, or Payerpath (Veridigm),  they may use Change Healthcare for certain functions, and
• The above companies have already removed their connection to Change Healthcare.

The first question to ask: Is Change Healthcare your primary clearinghouse?

If Change Healthcare is your primary clearinghouse, you will need another option to file your claims:

a.   Choose another clearinghouse (the three listed are the most common)

b.   File the claims directly on the payor portal

c.   Determine whether the payor will accept mailed-in claims

d.   Optum, a health services company that is also owned by UnitedHealth, said it has established a temporary assistance program to extend cash to organizations whose payment systems have been affected. This involves short-term loans that would need to be repaid once Change Healthcare is back up and running

• To determine eligibility and funding amount, you must register for the program. An Optum Pay account is required to complete registration, to receive funds, and to repay funds. Use your existing Optum Pay account or sign-up for Optum Pay to log-in.
• Once you enroll, you can see the potential temporary funding assistance
• Read all terms and conditions carefully and evaluate whether this option is best for your practice
• Temporary Funding Assistance (optum.com)

If Availity, Payerpath or Waystar is your primary clearinghouse, continue to monitor notices on their website for advice and the workarounds they have created.

• Some electronic payments from many payors are processed via Change Healthcare

If Change Healthcare is not your clearinghouse,

• Check your clearinghouse portal for a list of the affected payor payments
• Look for patterns of non-payment by payor
• If you can, contact the specific payor contact number (on the back of a patient’s cards), and ask if receiving paper checks is acceptable

Additional Information:

The United Health Group provides regular website updates regarding the Change Healthcare status.

• Information on the Change Healthcare Cyber Response - UnitedHealth Group

Additionally, according to an HHS press release from yesterday, CMS strongly encourages Medicaid and CHIP managed care plans to expedite the new iEDI enrollment and adopt strategies for removing or relaxing prior authorization and utilization management requirements, and consider offering advance funding to providers, on behalf of Medicaid and CHIP managed care enrollees to the extent permitted by the State.

In addition, the AAP is connecting with the CDC related to VFC implications, particularly borrowing across VFC and private vaccine stock.

Stay tuned for additional updates as we learn more about the ransomware attack and its impact on our practices.

As of 3/6/2024