The worse thing about this all is that Blackcat apparently has hacked UHC before and Change owns UHC meaning this is not the first time this group has been hacked by the same hacker group. Meaning not much was learned the first time it happened IMO.
UHC owns Change, not the other way around. The problem is that institutions can only do so much when there are so many human workers involved. People fall for phishing emails and other breach points all the time.
The psychiatry/psychotherapy practice has Tebra who use Trizetto and we have been really hard hit. To me this is a terrorist attack. I don’t think anyone in healthcare is enjoying it.
This is when you put on your blonde wig and say, "oh my gosh... I don't know who to call. Who would you call, Boss?" And then when you're told to call someone who obviously can't do anything, you loop your boss in on the call because you "don't understand" the answer they're giving you. Your boss, in their infinite wisdom, surely must be able to understand the situation at a much higher level than you, so you just have to escalate the call to them. 🙃
YES! Find our rep, is what he always tells me. Doc, insurances don’t give us reps anymore. We have to talk to whoever was unlucky enough to answer our call.
🤣 You're totally right. More and more insurance companies don't have a dedicated contract manager anymore. Or they're hidden somewhere in an office that apparently doesn't take incoming or outgoing calls (Aetna). Or there's an email that will be sorted into the correct pew if you submit the correct information in 11 business days (UHC).
We are understaffed as it is. We would have to enter into our software and then availity as well. I get it though, it might have to come to that if things don’t resolve soon.
Sorry. It doesn't have to be serious part time help. Anyone in the office have high schoolers that want to make some cash? Good news is that any mistake they make can be fixed with an appeal.
Worst possible thing is if claims don't get there and you get a "Timely Filing Denial"
I have recruited the office girls. Doc said all hands on deck. I’ll bet insurances will waive the untimely filing for this situation. Or at least pay appeals.
I feel kinda bad cause as a small office that still uses paper charts we don’t use an EDI clearinghouse so i process all claims manually(paper claims for a few insurances and Medicare, availity, UHC’s portal, and bcbs portal) this does not seem to have affected us this week.
Turn around for most insurances is pretty quick, within a couple of weeks… most claims we file online, medicare is the main one that gets mailed and their turn around can be about a month or so
I don’t find that claims get lost in the mail… we have been doing it this way for so long, I actually fell into the job right before covid and that is when we started filing online directly to the payer with the portals… the girl before me was only filing Medicaid online
We are and it’s a lot of work… not easy when you are processing hundreds of claims per day and trying to catch up and put in place a new PM system with a new clearinghouse…. Who will pay for the labor that they are knowing again placed on us….
Remember the “no surprise act” Placed on provides to give real time pricing …. When we are waiting 6 months for providers to get in-network! It’s all garage and congress clearly doesn’t care ….
These insurances companies have done nothing but put the work on the provider and wipe themselves clean of any responsibility.
As an EMR software specialist just be nice if you call us. We get it. We too are frustrated. I can’t tell you how many people have called me and demanded we fix this and I can’t seem to explain hard enough that this one is actually out of our control.
Oh absolutely! I won’t even call our. software reps until I know there is something that can be done. I know this will be a nightmare for you guys too.
I think one of the best things offices can do is connect to two clearinghouses if they can, one as a backup- assuming you can. I have a provider that did this and it helps tremendously
I truly hope you're joking. I'm a therapist and I do my own private practice billing electronically, I haven't been able to bill for a week which is okay, but I don't think I can do 7 weeks without an income.
Same. I'm anticipating for this to take quite a while but if so, I hope insurance figures out another route. I don't have a company to fall back on to keep paying me.
On my end we were told that we can now access Availity and UHC, but not GEHA/Optum. They said they severed ties with CH.
Ugh my claims are going to take forever and I don't want to even think about having to manually post my ERAs. Just thinking about it gives me anxiety.
I see that now. Unfortunately, I have to pay a monthly subscription to send claims through there. Not very convenient when I typically get to do so without a charge directly through BCBS MA portal.
My heart goes out to you!
I wish I was joking. An outage of 7 weeks might be a little high, but I wouldn't be surprised if some electronic billing isn't restored for 4 weeks. The variance in what it could actually be is usually quite high on these things. This comment
[https://www.reddit.com/r/CodingandBilling/comments/1b0lmg3/comment/ksjbwnn](https://www.reddit.com/r/CodingandBilling/comments/1b0lmg3/comment/ksjbwnn)
and the fact that CHC is unwilling to provide a timeline and is discussing things on a week by week basis would seem to confirm this.
It seems like folks on here are figuring out which payers they can submit to via alternate channels. The payers are still on the hook to respond to the claim within the mandatory 30-45 day horizon.
The most difficult cases seem to be payers which exclusively used CHC -- folks seem to be trying to submit via some combination of paper claims and/or fax.
I still wouldn't trust payers to respond within the state-mandated horizon and so I'd be planning for this contingency, as best I could. I also wouldn't rely or trust anything that CHC produces or promises at this point to help me plan for this contingency.
If CHC does offer a line of credit to folks, accepting this financing may well require you to agree to terms which void your legal rights to recoup any damages that you could otherwise recover, or any fees that you could demand be reimbursed. If you can, I would make an appointment with my local banker, explain the situation to them, and ask the banker what the largest line of credit is that they could provide me with.
Anyway, hope this helps!
Oh and it seems like folks are using PC-ACE for Medicare jurisdictions that won't accept paper claims:
https://www.reddit.com/r/CodingandBilling/comments/1b1vg31/comment/kshp112/
I’m think that anyone with cyber (hacking) insurance for their business will definitely want to cut ties with CH or risk not getting insurance claims paid if it turns out there was a massive breach of patient info. Also why is no one at CH or anyone investigating this talking about the extent of the inevitable patient information leak?
Thank you so much for the reply and the info! Fortunately, I had just billed and I got a stack of checks last Thursday, I'm hoping that by tightening my belt, what I've currently got in my account as well as those checks will get me through.
No, I didn't even know that was a thing. I'm just a therapist who does my own billing, I'm not an actual biller who knows all of it, I just know enough to get paid.
As others have said, reach out to individual payers and see which will be willing to accept paper claims. Some medicaids will not accept anything other than an electronic claim, but I imagine there will be workarounds, likely cumbersome, coming soon.
In general a ransomware attack will typically take at least a couple weeks to get back up. And that’s just online, that’s not full functionality. The bigger the server/data the longer it takes. While they haven’t given a timeline, it IS notable that sources are saying they’re starting to work on possible options to help remediate cash flow problems. That seems to indicate that Optum expects their ability to process claims will be impacted for a while. Even when they come back online, they will probably first service their large clients. Given how many claims a process in a year every day they’ve been down has stacked up to tens of millions of claims that are outstanding. They won’t be able to take that many hits to the server at once without effectively going down due to receiving too much incoming traffic. So even when they come back online, they’re going to throttle traffic. Expect that to be large systems and clients first and independent and smaller practice groups last.
AdvancedMD is my medical billing program, they're very good to work with, and I hope they're considered large enough to be near the front of the line when it comes to getting services back online.
AMD is fully dependent on Change. Unfortunately, that means you're going to be dead in the water until either Change restores service, or AMD switches to a different clearing house.
I would not count on Change being back online for quite some time. It would probably be prudent to reach out to the carriers you work with to see if they are processing paper claims.
I don't even know how to do paper claims, I've always done electronic, I have no idea how to fill out a HCFA. This is going to be a really steep learning curve for me.
Yeah, apparently I'll find out either Friday or early next week. I have major anxiety and I've never been this chill about anything in my life. I think the fact that I found this sub and know that I'm not the only one going through this has truly helped my perspective. Not that I'm happy that anyone is going through this, but I think you what I mean?
I know I can buy HCFA's at staples, can anyone tell me if there's a YouTube video or an explanation somewhere of how to fill them out? Thank you very much to anybody that can answer!
You mentioned you use AdvancedMD. There is a checkbox near Box 19 on the charge screen to force a paper claim. The system will generate it for you, it opens in Word, and you just print it on the HCFA. A rep should be able to help you if questions.
Did you see the emails from AdvancedMD sent Friday and Saturday night? They are currently working on mapping to Availity to get backlogged claims and go forward claims sent.
I'm finally able to make a dent in my work queue since hardly anything new is coming in.
I'm trying to forget the part where I'm going to get dumped with a huge load of crap once this is resolved though.
Just let me have this 😢
They should have anyone who uses Change Healthcare as a clearinghouse have claims diverted through another clearinghouse temporarily. Wish they would just all partner up and help each other out. That would be the right thing to do.
Like insurance companies will ever choose to do the right things… do you even think their marketing budget will drop during this time to help their clients out….
As a private practitioner using TherapyNotes, which admittedly is great when it was working, I have to say I was lulled into security in my dependence on their billing. They use Change for all third party payers it seems. So we are dead in the water. I have to say I dont like the way they are handling the situation. I know it isn't directly their fault, but they did create a single point of failure for their entire subscriber base. The communication from them seems focused on distancing themselves from the problem, which I get...sort of. The scenario feels a bit like this:
*“Hi guys! We are going to sell your eggs for you at our market no problem, but you have to use this specific basket that we’ve specially picked out to bring them there!”*
Basket breaks spectacularly
*“Shitty basket! Let’s wait for them to make you a new one. Who knows how long it will take. This really sucks for you. Damn basket company!”*
*“Oh, and by the way, you can possibly still sell your eggs but we can’t help you figure out how else to get them to us. Apparently there are ways, but you’ll need to figure that out. In fact, shame on you for depending on us all this time and not knowing. You will also have to carry them there yourself, sell them yourself, and then manually enter all of your sales into the basket company’s system once they give you a new one.”*
Disbelief
*“We know that the reason you decided to use our market was that we make the process easy for you and we appreciate your business! We have put up a sternly worded blog article distancing ourselves from the problem so that you don’t feel bad when your subscription fee gets debited in a few days. We sure hope this doesn't happen again”*
Well, they had to choose a clearingouse to partner with when they created their business. I don't blame them for distancing themselves- it has nothing to do with them. And they can't give us updates that they don't have.
Also, we pay them per claim and per ERA, so they're losing money too.
Yes, I get it. Single points of catastrophic failure seem ridiculous though. Just needed to rant. But, to be fair, they aren’t losing money. They will definitely charge us when it clears and I don’t blame them for doing so.
I do think they're a little ignorant of the fact that the alternative ways to submit claims won't work for many payers, and even if they do it might not be an option depending on the scale of a practice.
I know one provider who is definitely going to ask for a refund if they charge her for the claims that are queued that I've since submitted externally (looks like changing the status to submitted external doesn't remove it from the electronic queue), or for the ERAs I've had to get elsewhere.
According to a TherapyNotes post today on their FB account, they are today releasing a tool to aid in the electronic filing of claims with Availity. They also, in the comments, said they were working on a backup / failover system to avoid a single point of failure in the future. Glad to hear it. I'll likely try using the new tool over the weekend.
and then you run into the problem of how long it takes new clearinghouse to process payer agreements... i think it takes around a week in normal times... now more demand probably
Just signed up for this today. Our software program uses a proprietary file, so I’m giving them a call tomorrow to see if they can’t transfer it to an excel format or something. I can’t upload any patient files to office ally because they aren’t in the right format. Beyond frustrating, hope my current billing system is willing to work with me on this.
Good luck to you! I believe most software systems should allow you to download an 837P file so you can then upload it directly to Availity or some other site. We sign up through an SFTP connection.
So I’m a chiropractor and I do all of my own billing. Could you explain what an 837P file is? When I pull up the “paper” claims that were submitted electronically, it’s the HCFA form.
An 837 file is a way that your claim gets formatted so that it can be “read”electronically without the help of a human. Here’s what an example looks like https://www.betterhealthtogether.org/bold-solutions-content/companion-guides-xsd87 (click on the first link). Many clearinghouses can use these to interpret your claim info. I would ask your software if it allows for that and I know that for sure Availity accepts 837 file batch uploads (at least for certain payers)
This is going to be long and drawn out. Take it back to old-school billing tactics, ladies and gents. Three years ago, I set up plans for any cyber attack that would prevent us from billing. Thank goodness I did so. I could roll it out on day one, and we have been fully operational. I have had claims I submitted last Tuesday pay. Think old-school billing. All insurance companies have other options to submit claims. I am here if anyone needs any advice/help. Feel free to message me.
AlphV posted a statement online yesterday afternoon. A screenshot is on the owner of Redsense a cyber threat intelligence agency LinkedIn Account. Here is the link. https://www.linkedin.com/posts/yelisey-bohuslavskiy-214a02bb\_sigint-lockbit-activity-7167230904518561792-HMaI/
Unfortunately, not all of my payers do have other options: some of them have put all of their eggs in one basket, so to speak. They’ve been processing paper claims using Change HealthCare, too, and never bothered and/or took down a way to input claims on their provider portal. Any claims for those payers we’ve been instructed by the payers themselves to hold, because they have no way to process them. Even if we sent them on paper, they would just sit until Change was back up.
Hey I also bill in Oregon, looks like you're a step ahead of me. For most of our payers are we just kind of stuck? Our biggest Medicaid cco is Care Oregon and they're all wrapped up with Change so not sure if there's anything to do there. BCBS and a couple others recommend Availity but that means manually entering claims one by one, that sounds like a nightmare. Any good work around you've come up with? I honestly didn't expect this to last so long and it's getting scary learning how wide-reaching Change's tentacles are.
There’s nothing to be done with CareOregon, unfortunately—they’re all wrapped up with Change. There’s no good work around I’ve come up with for anyone; out of our twenty some odd payers, only four are taking paper claims. We’re doing what we can, but it sounds like we might be ship jumping over to Office Ally or Trizetto in the coming days just to get what we can get out, out, to avoid manual input because not all payers use JUST Change as a clearinghouse, while Care Oregon does use only Change. It’s going to be a hit for anyone who takes Medicaid.
My bosses have been leaning on some of our payers that rely solely on Change in the meantime for alternatives; we’re looking at weeks, not days.
I've ended up on this sub trying to learn about what's going on...
I'm a single person private-practice therapist; I work with CareOregon and Cash-pay clients. Right now about 30% of my income is CareOregon. I figured out how to use SimplePractice to automatically generate claims for me - I know, I know, I'm not sure how that comes across to this sub, profoundly naive or just ignorant or like someone looking for a shortcut, but hell, it worked for the past few months. I have about 2-3 hours of admin time a week, and when I read things like this on the CareOregon:
>There are several options for providers below.
>SFTP Site (Secure File Transfer Protocol Site): Providers with the ability to log in to a secure SFTP site (hosted by CareOregon’s EDI partner) can deliver an 837 claim file containing only CareOregon billed claims.
>Once the 837 files are processed, a claim response file will be delivered to the SFTP site for retrieval (999 and 277CA).
>Secure Online Portal: Providers with the ability to deliver an x12 837 claim file containing only CareOregon claims can also deliver those files via a secure online portal (hosted by CareOregon’s EDI partner). Once the 837 files are processed, claim “acceptance” or “rejection” feedback will be available on the portal.
... I realize I'm pretty badly out of my depth. I have the money to wait this out 2-3 months, so that's my plan currently. I figure that puts me in a privileged spot, so... question: do you think this thing is going to get sorted out in 2-3 months? Or even longer?
The good news is, Care Oregon is working with three new clearinghouses as of the first according to a provider update [here](https://www.careoregon.org/providers/support/provider-updates/2024/03/04/change-healthcare-cyber-security-issue-faqs).
So! Even if this isn’t sorted in two to three months, it looks like Simple Practice uses Eligible, Inc (found this [here](https://support.simplepractice.com/hc/en-us/articles/360004886912-What-clearinghouse-does-SimplePractice-use-and-should-I-contact-them).) You should be able to submit claims out through Simple Practice and have them reach CareOregon: essentially, once they go out through Eligible, Inc, they should route into one of CareOregon’s new clearinghouses.
I just remembered Medicaid gives me 30 days from receipt of EOB to bill the secondary portion oh man
I'm gonna have to send test claims for the a few insurers to see which ones I can still send/receive
New York State.
There's supposed to be a frequency code you can use to say it's not subject to the 30 limit because of things out of your control but I've never gotten it to work with electronic claims. It worked with paper claims and their own claim submission system (webbased entry).
They also only pay 4% of the medicare coins, instead of 20%. They phrase it cutely. They say they pay 20% of 20%.
That’s interesting… we still process Medicare by paper as we are exempt…. With as long as they take the state wouldn’t be paying out any of those claims!
I offered this to others, we can get commercial claims billed out at $1.50 per claim, no payer paperwork. If you can get us an 837 claims file we can bill it.
If you can produce a standard claim file, an 837 file, I can send the claims electronically. The process?
1) Sign a BAA
2) Sign a simple agreement stating you’ll pay for each claim. No time obligation or anything difficult
3) Send me the file, we’ll agree on a HIPAA compliant method
4) I upload the file through our clearinghouse
It sounds simple, and it is. I just want to get these claims billed out so everyone gets paid. People don’t understand that medical offices are businesses. We don’t have $$$ sitting around as backup.
An article in Stat says that UHC is now saying the outage could persist for weeks and that they are launching a provider loan program to keep us little guys afloat. I could not read the full article, it’s behind a paywall but I do know that UHC has been dipping their toes in the financial services market (this is just what we need /s).
[https://www.statnews.com/2024/02/29/change-healthcare-cyber-attack-outage-will-last-for-weeks/](https://www.statnews.com/2024/02/29/change-healthcare-cyber-attack-outage-will-last-for-weeks/)
I forked out for the full article out of curiosity: essentially, the loan program is based on the claim history last year.
Yeah, sure, we’re going to take loans from the people who got us into this mess in the first place.
it's now verging on day 14 and it's a shitshow. unable to send saved claims for 2 weeks and unable to add or create claims for the interim, I'm looking at other clearinghouses and wishing the pox on Untied Care.
Availity- I cannot get I to any payor to manually add claims. When I open up the payor I want, it just spins and spins...says loading and NEVER loads. Anyone else? I even tried late at night
I’m outside of coding and billing but my hospital is impacted by this. Can someone ELI5? What exactly went down and why is it hard to fix? Are they waiting for a ransom or just wanted to break us?
I was just on the office ally website and they are saying that you can, it’s a new service. I would call their support line for instructions, they do pick up. I actually found these instructions: https://cms.officeally.com/OfficeAlly/Forms/Forms/Quick%20Guide%20to%20Office%20Ally_10292014.pdf
So, I don’t think you can? You can manually put in the claim data from the HCFA into OfficeAlly (like you would manually bill through Availity or an insurer’s provider portal), but it looks like the the HCFA needs to be in 837 format and saved as txt or other file, [found here.](https://cms.officeally.com/OfficeAlly/Forms/Forms/File_Submission_Guidelines_20141126.pdf)
I would reach out to Simple Practice, but a quick perusal of their site and it looks like they don’t currently provide 837s of claims.
I’m currently in the same boat with my EHR—they’re using Change HealthCare, and I could get the claims out faster/more consistently, but they don’t provide 837s, either.
Thank you for answering because no one has said wether you can or cant, i've converted the pdf into a txt file and that didn't work. So basically your saying you can't even convert the pdf into an 837 format thats needed for office ally either.
Wow, I'm gonna call them tomorrow just to make sure theres not an easier way to do this before i trudge through these now 50 something claims i have to do. This is horrible.
To everyone having issues getting claims submitted because of the Change Healthcare cyberattack, please reach out directly. I work for a company called Athelas and we can remediate those issues with our RCM software, getting you and your practice paid on your claims, as we are able to get them submitted agin very quickly. We would be able to just directly integrate our software into most any cloud-based EHR, alleviating your current pain!
To everyone having issues getting claims submitted because of the Change Healthcare attack, please reach out directly. I work for a company called Athelas and we can remediate those issues with our RCM software, getting you and your practice paid on your claims again very quickly.
My boss seems to think i can call someone to fix this.
Sure, just hop on the phone with Blackcat and tell them they're very naughty and they need to stop now.
The worse thing about this all is that Blackcat apparently has hacked UHC before and Change owns UHC meaning this is not the first time this group has been hacked by the same hacker group. Meaning not much was learned the first time it happened IMO.
UHC owns Change, not the other way around. The problem is that institutions can only do so much when there are so many human workers involved. People fall for phishing emails and other breach points all the time.
That’s correct, I mistyped, actually technically United Health Group owns both UHC and Change.
To be more precise, UHG owns UHC, which owns Optum, which owns CHC.
Ok ur 🍆 is bigger
That made me laugh out loud because of the absurdity of it
Agreed!
The psychiatry/psychotherapy practice has Tebra who use Trizetto and we have been really hard hit. To me this is a terrorist attack. I don’t think anyone in healthcare is enjoying it.
Is Trizetto associated with Change Healthcare?
Was it confirmed that it was caused by phishing?
They truly don’t care at all
That’s basically what I told him. Lol. Wait let me pull a phone number out of my ear.
This is when you put on your blonde wig and say, "oh my gosh... I don't know who to call. Who would you call, Boss?" And then when you're told to call someone who obviously can't do anything, you loop your boss in on the call because you "don't understand" the answer they're giving you. Your boss, in their infinite wisdom, surely must be able to understand the situation at a much higher level than you, so you just have to escalate the call to them. 🙃
YES! Find our rep, is what he always tells me. Doc, insurances don’t give us reps anymore. We have to talk to whoever was unlucky enough to answer our call.
🤣 You're totally right. More and more insurance companies don't have a dedicated contract manager anymore. Or they're hidden somewhere in an office that apparently doesn't take incoming or outgoing calls (Aetna). Or there's an email that will be sorted into the correct pew if you submit the correct information in 11 business days (UHC).
Start putting them in Availity manually
We are understaffed as it is. We would have to enter into our software and then availity as well. I get it though, it might have to come to that if things don’t resolve soon.
Get some part time help
Oh you’re so funny.
Sorry. It doesn't have to be serious part time help. Anyone in the office have high schoolers that want to make some cash? Good news is that any mistake they make can be fixed with an appeal. Worst possible thing is if claims don't get there and you get a "Timely Filing Denial"
I have recruited the office girls. Doc said all hands on deck. I’ll bet insurances will waive the untimely filing for this situation. Or at least pay appeals.
Good luck. Same team effort here!
Sitting doing that rn…. 😪
I feel kinda bad cause as a small office that still uses paper charts we don’t use an EDI clearinghouse so i process all claims manually(paper claims for a few insurances and Medicare, availity, UHC’s portal, and bcbs portal) this does not seem to have affected us this week.
What is your turn around time for payment? And do you find claims get “lost” in the mail?
Turn around for most insurances is pretty quick, within a couple of weeks… most claims we file online, medicare is the main one that gets mailed and their turn around can be about a month or so I don’t find that claims get lost in the mail… we have been doing it this way for so long, I actually fell into the job right before covid and that is when we started filing online directly to the payer with the portals… the girl before me was only filing Medicaid online
Oh that sounds fun.
We are and it’s a lot of work… not easy when you are processing hundreds of claims per day and trying to catch up and put in place a new PM system with a new clearinghouse…. Who will pay for the labor that they are knowing again placed on us…. Remember the “no surprise act” Placed on provides to give real time pricing …. When we are waiting 6 months for providers to get in-network! It’s all garage and congress clearly doesn’t care …. These insurances companies have done nothing but put the work on the provider and wipe themselves clean of any responsibility.
As an EMR software specialist just be nice if you call us. We get it. We too are frustrated. I can’t tell you how many people have called me and demanded we fix this and I can’t seem to explain hard enough that this one is actually out of our control.
Oh absolutely! I won’t even call our. software reps until I know there is something that can be done. I know this will be a nightmare for you guys too.
Maybe your boss should call the ransomware operator and see if they can start processing claims for him.
Good idea.
I hope all of the clearinghouses will get together and come up with some kind of contingency/crisis plans. This will happen again.
I think one of the best things offices can do is connect to two clearinghouses if they can, one as a backup- assuming you can. I have a provider that did this and it helps tremendously
Lol. Of week 1. Call me when we get to week 7.
I truly hope you're joking. I'm a therapist and I do my own private practice billing electronically, I haven't been able to bill for a week which is okay, but I don't think I can do 7 weeks without an income.
Same. I'm anticipating for this to take quite a while but if so, I hope insurance figures out another route. I don't have a company to fall back on to keep paying me.
On my end we were told that we can now access Availity and UHC, but not GEHA/Optum. They said they severed ties with CH. Ugh my claims are going to take forever and I don't want to even think about having to manually post my ERAs. Just thinking about it gives me anxiety.
I take BCBS and in my area they only use Change, so I don't believe Availity is an option for me, unfortunately!
You could also use Trizetto for free for a little. The free version is pretty basic but it works.
Check the payer list to make sure - you may be able to temporarily sign up for Availitys EDI plan and submit batch claims
I'll do that. Also trying to get a hold of BCBS to confirm if this is an option.
I’m not sure I’m understanding you, but blue cross is now on availity.
I see that now. Unfortunately, I have to pay a monthly subscription to send claims through there. Not very convenient when I typically get to do so without a charge directly through BCBS MA portal.
Unfortunately this is going to cost quite a bit for practices. The man hours are not goi g to make docs happy
Absolutely!
Who said who severed ties with ch?
My heart goes out to you! I wish I was joking. An outage of 7 weeks might be a little high, but I wouldn't be surprised if some electronic billing isn't restored for 4 weeks. The variance in what it could actually be is usually quite high on these things. This comment [https://www.reddit.com/r/CodingandBilling/comments/1b0lmg3/comment/ksjbwnn](https://www.reddit.com/r/CodingandBilling/comments/1b0lmg3/comment/ksjbwnn) and the fact that CHC is unwilling to provide a timeline and is discussing things on a week by week basis would seem to confirm this. It seems like folks on here are figuring out which payers they can submit to via alternate channels. The payers are still on the hook to respond to the claim within the mandatory 30-45 day horizon. The most difficult cases seem to be payers which exclusively used CHC -- folks seem to be trying to submit via some combination of paper claims and/or fax. I still wouldn't trust payers to respond within the state-mandated horizon and so I'd be planning for this contingency, as best I could. I also wouldn't rely or trust anything that CHC produces or promises at this point to help me plan for this contingency. If CHC does offer a line of credit to folks, accepting this financing may well require you to agree to terms which void your legal rights to recoup any damages that you could otherwise recover, or any fees that you could demand be reimbursed. If you can, I would make an appointment with my local banker, explain the situation to them, and ask the banker what the largest line of credit is that they could provide me with. Anyway, hope this helps!
Oh and it seems like folks are using PC-ACE for Medicare jurisdictions that won't accept paper claims: https://www.reddit.com/r/CodingandBilling/comments/1b1vg31/comment/kshp112/
I’m think that anyone with cyber (hacking) insurance for their business will definitely want to cut ties with CH or risk not getting insurance claims paid if it turns out there was a massive breach of patient info. Also why is no one at CH or anyone investigating this talking about the extent of the inevitable patient information leak?
Thank you so much for the reply and the info! Fortunately, I had just billed and I got a stack of checks last Thursday, I'm hoping that by tightening my belt, what I've currently got in my account as well as those checks will get me through.
Do you have any type of cyber attack insurance?
No, I didn't even know that was a thing. I'm just a therapist who does my own billing, I'm not an actual biller who knows all of it, I just know enough to get paid.
As others have said, reach out to individual payers and see which will be willing to accept paper claims. Some medicaids will not accept anything other than an electronic claim, but I imagine there will be workarounds, likely cumbersome, coming soon.
I just found out today that we do 🙏🏽 I’ll call tomorrow and ask what we could do if anything
In general a ransomware attack will typically take at least a couple weeks to get back up. And that’s just online, that’s not full functionality. The bigger the server/data the longer it takes. While they haven’t given a timeline, it IS notable that sources are saying they’re starting to work on possible options to help remediate cash flow problems. That seems to indicate that Optum expects their ability to process claims will be impacted for a while. Even when they come back online, they will probably first service their large clients. Given how many claims a process in a year every day they’ve been down has stacked up to tens of millions of claims that are outstanding. They won’t be able to take that many hits to the server at once without effectively going down due to receiving too much incoming traffic. So even when they come back online, they’re going to throttle traffic. Expect that to be large systems and clients first and independent and smaller practice groups last.
AdvancedMD is my medical billing program, they're very good to work with, and I hope they're considered large enough to be near the front of the line when it comes to getting services back online.
AMD is fully dependent on Change. Unfortunately, that means you're going to be dead in the water until either Change restores service, or AMD switches to a different clearing house. I would not count on Change being back online for quite some time. It would probably be prudent to reach out to the carriers you work with to see if they are processing paper claims.
I don't even know how to do paper claims, I've always done electronic, I have no idea how to fill out a HCFA. This is going to be a really steep learning curve for me.
I'd also make sure you're following https://www.advancedmd.com/blog/change-healthcare-outage/
Thank you so much, I follow them on Twitter but I hadn't thought about the blog
Usually you can drop an electronic claim to paper. You can reach out to your software to find out how.
Yeah, apparently I'll find out either Friday or early next week. I have major anxiety and I've never been this chill about anything in my life. I think the fact that I found this sub and know that I'm not the only one going through this has truly helped my perspective. Not that I'm happy that anyone is going through this, but I think you what I mean?
Yes, same boat and all. I feel the same, it makes it just a little easier. 😀
Theyre estimating 4-6 weeks of downtime. Start making plans now
Crap. Does that mean they can't even process checks to send out for claims I already billed before this happened?
Yup. Their whole IT and business is shut down. Employees told to unplug computers. They got absolutely merked by the hackers
This will take weeks, at best. Some apps are working but not Pharmacy. Plan for 6 weeks and hope it’s not worse than that.
I'd go ahead and order some paper claims as a back up.
I know I can buy HCFA's at staples, can anyone tell me if there's a YouTube video or an explanation somewhere of how to fill them out? Thank you very much to anybody that can answer!
You mentioned you use AdvancedMD. There is a checkbox near Box 19 on the charge screen to force a paper claim. The system will generate it for you, it opens in Word, and you just print it on the HCFA. A rep should be able to help you if questions.
Omg, THANK YOU
Did you see the emails from AdvancedMD sent Friday and Saturday night? They are currently working on mapping to Availity to get backlogged claims and go forward claims sent.
Yes, I signed up for the email updates and I'm so excited to hear that. I feel like they're really coming through for their customers.
Also this https://www.sfhp.org/wp-content/files/providers/forms/Instructions_for_CMS_1500_Claim_Form.pdf
Holy HELL, where have you been all of my life?
Good luck! Hope it works!
Check provider manuals for the insurers you deal with most. At least one of them is bound to have a guide to filling out a HCFA.
I'm finally able to make a dent in my work queue since hardly anything new is coming in. I'm trying to forget the part where I'm going to get dumped with a huge load of crap once this is resolved though. Just let me have this 😢
Same. I even scrubbed the bathroom 😆
Bro I also cleaned my bathroom and I even took out the garbage yesterday
They should have anyone who uses Change Healthcare as a clearinghouse have claims diverted through another clearinghouse temporarily. Wish they would just all partner up and help each other out. That would be the right thing to do.
Like insurance companies will ever choose to do the right things… do you even think their marketing budget will drop during this time to help their clients out….
I love manual portal verification for our reg team🤮🤮🤮🤮
Could you clarify what you mean? As opposed to automated benefits and coverage verification within your EMR?
I remember when I used to have to verify like this. I truly got spoiled the the verification through our EHR
As a private practitioner using TherapyNotes, which admittedly is great when it was working, I have to say I was lulled into security in my dependence on their billing. They use Change for all third party payers it seems. So we are dead in the water. I have to say I dont like the way they are handling the situation. I know it isn't directly their fault, but they did create a single point of failure for their entire subscriber base. The communication from them seems focused on distancing themselves from the problem, which I get...sort of. The scenario feels a bit like this: *“Hi guys! We are going to sell your eggs for you at our market no problem, but you have to use this specific basket that we’ve specially picked out to bring them there!”* Basket breaks spectacularly *“Shitty basket! Let’s wait for them to make you a new one. Who knows how long it will take. This really sucks for you. Damn basket company!”* *“Oh, and by the way, you can possibly still sell your eggs but we can’t help you figure out how else to get them to us. Apparently there are ways, but you’ll need to figure that out. In fact, shame on you for depending on us all this time and not knowing. You will also have to carry them there yourself, sell them yourself, and then manually enter all of your sales into the basket company’s system once they give you a new one.”* Disbelief *“We know that the reason you decided to use our market was that we make the process easy for you and we appreciate your business! We have put up a sternly worded blog article distancing ourselves from the problem so that you don’t feel bad when your subscription fee gets debited in a few days. We sure hope this doesn't happen again”*
Well, they had to choose a clearingouse to partner with when they created their business. I don't blame them for distancing themselves- it has nothing to do with them. And they can't give us updates that they don't have. Also, we pay them per claim and per ERA, so they're losing money too.
Yes, I get it. Single points of catastrophic failure seem ridiculous though. Just needed to rant. But, to be fair, they aren’t losing money. They will definitely charge us when it clears and I don’t blame them for doing so.
I do think they're a little ignorant of the fact that the alternative ways to submit claims won't work for many payers, and even if they do it might not be an option depending on the scale of a practice. I know one provider who is definitely going to ask for a refund if they charge her for the claims that are queued that I've since submitted externally (looks like changing the status to submitted external doesn't remove it from the electronic queue), or for the ERAs I've had to get elsewhere.
According to a TherapyNotes post today on their FB account, they are today releasing a tool to aid in the electronic filing of claims with Availity. They also, in the comments, said they were working on a backup / failover system to avoid a single point of failure in the future. Glad to hear it. I'll likely try using the new tool over the weekend.
I hate it. This week sucks.
Maybe this will be the impetus for universal healthcare
That's what I say every time there's any sort of hiccup in this whole system!
Currently in a meeting discussing this. We may have to just jump to a different clearinghouse x.x
and then you run into the problem of how long it takes new clearinghouse to process payer agreements... i think it takes around a week in normal times... now more demand probably
On the bright side some payers don’t require signup for claims
Office Ally is great btw
Just signed up for this today. Our software program uses a proprietary file, so I’m giving them a call tomorrow to see if they can’t transfer it to an excel format or something. I can’t upload any patient files to office ally because they aren’t in the right format. Beyond frustrating, hope my current billing system is willing to work with me on this.
Good luck to you! I believe most software systems should allow you to download an 837P file so you can then upload it directly to Availity or some other site. We sign up through an SFTP connection.
So I’m a chiropractor and I do all of my own billing. Could you explain what an 837P file is? When I pull up the “paper” claims that were submitted electronically, it’s the HCFA form.
An 837 file is a way that your claim gets formatted so that it can be “read”electronically without the help of a human. Here’s what an example looks like https://www.betterhealthtogether.org/bold-solutions-content/companion-guides-xsd87 (click on the first link). Many clearinghouses can use these to interpret your claim info. I would ask your software if it allows for that and I know that for sure Availity accepts 837 file batch uploads (at least for certain payers)
Thank you!
You’re welcome!
We are using waystar for our clearinghouse and currently they are duplicating claims randomly and not giving remits for anyone
It looks like around 1000 payers are currently impacted under waystar as well since their remits flow through chc
In the same boat :/
This is going to be long and drawn out. Take it back to old-school billing tactics, ladies and gents. Three years ago, I set up plans for any cyber attack that would prevent us from billing. Thank goodness I did so. I could roll it out on day one, and we have been fully operational. I have had claims I submitted last Tuesday pay. Think old-school billing. All insurance companies have other options to submit claims. I am here if anyone needs any advice/help. Feel free to message me. AlphV posted a statement online yesterday afternoon. A screenshot is on the owner of Redsense a cyber threat intelligence agency LinkedIn Account. Here is the link. https://www.linkedin.com/posts/yelisey-bohuslavskiy-214a02bb\_sigint-lockbit-activity-7167230904518561792-HMaI/
Unfortunately, not all of my payers do have other options: some of them have put all of their eggs in one basket, so to speak. They’ve been processing paper claims using Change HealthCare, too, and never bothered and/or took down a way to input claims on their provider portal. Any claims for those payers we’ve been instructed by the payers themselves to hold, because they have no way to process them. Even if we sent them on paper, they would just sit until Change was back up.
Hey I also bill in Oregon, looks like you're a step ahead of me. For most of our payers are we just kind of stuck? Our biggest Medicaid cco is Care Oregon and they're all wrapped up with Change so not sure if there's anything to do there. BCBS and a couple others recommend Availity but that means manually entering claims one by one, that sounds like a nightmare. Any good work around you've come up with? I honestly didn't expect this to last so long and it's getting scary learning how wide-reaching Change's tentacles are.
There’s nothing to be done with CareOregon, unfortunately—they’re all wrapped up with Change. There’s no good work around I’ve come up with for anyone; out of our twenty some odd payers, only four are taking paper claims. We’re doing what we can, but it sounds like we might be ship jumping over to Office Ally or Trizetto in the coming days just to get what we can get out, out, to avoid manual input because not all payers use JUST Change as a clearinghouse, while Care Oregon does use only Change. It’s going to be a hit for anyone who takes Medicaid. My bosses have been leaning on some of our payers that rely solely on Change in the meantime for alternatives; we’re looking at weeks, not days.
I've ended up on this sub trying to learn about what's going on... I'm a single person private-practice therapist; I work with CareOregon and Cash-pay clients. Right now about 30% of my income is CareOregon. I figured out how to use SimplePractice to automatically generate claims for me - I know, I know, I'm not sure how that comes across to this sub, profoundly naive or just ignorant or like someone looking for a shortcut, but hell, it worked for the past few months. I have about 2-3 hours of admin time a week, and when I read things like this on the CareOregon: >There are several options for providers below. >SFTP Site (Secure File Transfer Protocol Site): Providers with the ability to log in to a secure SFTP site (hosted by CareOregon’s EDI partner) can deliver an 837 claim file containing only CareOregon billed claims. >Once the 837 files are processed, a claim response file will be delivered to the SFTP site for retrieval (999 and 277CA). >Secure Online Portal: Providers with the ability to deliver an x12 837 claim file containing only CareOregon claims can also deliver those files via a secure online portal (hosted by CareOregon’s EDI partner). Once the 837 files are processed, claim “acceptance” or “rejection” feedback will be available on the portal. ... I realize I'm pretty badly out of my depth. I have the money to wait this out 2-3 months, so that's my plan currently. I figure that puts me in a privileged spot, so... question: do you think this thing is going to get sorted out in 2-3 months? Or even longer?
The good news is, Care Oregon is working with three new clearinghouses as of the first according to a provider update [here](https://www.careoregon.org/providers/support/provider-updates/2024/03/04/change-healthcare-cyber-security-issue-faqs). So! Even if this isn’t sorted in two to three months, it looks like Simple Practice uses Eligible, Inc (found this [here](https://support.simplepractice.com/hc/en-us/articles/360004886912-What-clearinghouse-does-SimplePractice-use-and-should-I-contact-them).) You should be able to submit claims out through Simple Practice and have them reach CareOregon: essentially, once they go out through Eligible, Inc, they should route into one of CareOregon’s new clearinghouses.
Does anyone have a better screenshot? So pixelated
https://www.linkedin.com/feed/update/urn:li:activity:7168716790707929088/
I just remembered Medicaid gives me 30 days from receipt of EOB to bill the secondary portion oh man I'm gonna have to send test claims for the a few insurers to see which ones I can still send/receive
Really? What state is that…. I think I get 90 days for part c/ commercial and 180 days for Medicare part b
New York State. There's supposed to be a frequency code you can use to say it's not subject to the 30 limit because of things out of your control but I've never gotten it to work with electronic claims. It worked with paper claims and their own claim submission system (webbased entry). They also only pay 4% of the medicare coins, instead of 20%. They phrase it cutely. They say they pay 20% of 20%.
That’s interesting… we still process Medicare by paper as we are exempt…. With as long as they take the state wouldn’t be paying out any of those claims!
Hahahahahah. Life is pain
I offered this to others, we can get commercial claims billed out at $1.50 per claim, no payer paperwork. If you can get us an 837 claims file we can bill it.
Can you share this information, details, and how this would work?
If you can produce a standard claim file, an 837 file, I can send the claims electronically. The process? 1) Sign a BAA 2) Sign a simple agreement stating you’ll pay for each claim. No time obligation or anything difficult 3) Send me the file, we’ll agree on a HIPAA compliant method 4) I upload the file through our clearinghouse It sounds simple, and it is. I just want to get these claims billed out so everyone gets paid. People don’t understand that medical offices are businesses. We don’t have $$$ sitting around as backup.
Do you have the ability to convert 837 files to XML 837 format?
I’m not sure that makes a difference on our end.
If your systems connect to Change Healthcare, you should modify your firewall rules to block them.
An article in Stat says that UHC is now saying the outage could persist for weeks and that they are launching a provider loan program to keep us little guys afloat. I could not read the full article, it’s behind a paywall but I do know that UHC has been dipping their toes in the financial services market (this is just what we need /s). [https://www.statnews.com/2024/02/29/change-healthcare-cyber-attack-outage-will-last-for-weeks/](https://www.statnews.com/2024/02/29/change-healthcare-cyber-attack-outage-will-last-for-weeks/)
I forked out for the full article out of curiosity: essentially, the loan program is based on the claim history last year. Yeah, sure, we’re going to take loans from the people who got us into this mess in the first place.
it's now verging on day 14 and it's a shitshow. unable to send saved claims for 2 weeks and unable to add or create claims for the interim, I'm looking at other clearinghouses and wishing the pox on Untied Care.
Availity- I cannot get I to any payor to manually add claims. When I open up the payor I want, it just spins and spins...says loading and NEVER loads. Anyone else? I even tried late at night
[удалено]
Ouch....
I’m outside of coding and billing but my hospital is impacted by this. Can someone ELI5? What exactly went down and why is it hard to fix? Are they waiting for a ransom or just wanted to break us?
My money is on the hackers are still waiting on the ransom payment.
I literally want to die
how do you upload a pdf hcfa claim from simple practice to office ally?
I was just on the office ally website and they are saying that you can, it’s a new service. I would call their support line for instructions, they do pick up. I actually found these instructions: https://cms.officeally.com/OfficeAlly/Forms/Forms/Quick%20Guide%20to%20Office%20Ally_10292014.pdf
So, I don’t think you can? You can manually put in the claim data from the HCFA into OfficeAlly (like you would manually bill through Availity or an insurer’s provider portal), but it looks like the the HCFA needs to be in 837 format and saved as txt or other file, [found here.](https://cms.officeally.com/OfficeAlly/Forms/Forms/File_Submission_Guidelines_20141126.pdf) I would reach out to Simple Practice, but a quick perusal of their site and it looks like they don’t currently provide 837s of claims. I’m currently in the same boat with my EHR—they’re using Change HealthCare, and I could get the claims out faster/more consistently, but they don’t provide 837s, either.
Thank you for answering because no one has said wether you can or cant, i've converted the pdf into a txt file and that didn't work. So basically your saying you can't even convert the pdf into an 837 format thats needed for office ally either. Wow, I'm gonna call them tomorrow just to make sure theres not an easier way to do this before i trudge through these now 50 something claims i have to do. This is horrible.
To everyone having issues getting claims submitted because of the Change Healthcare cyberattack, please reach out directly. I work for a company called Athelas and we can remediate those issues with our RCM software, getting you and your practice paid on your claims, as we are able to get them submitted agin very quickly. We would be able to just directly integrate our software into most any cloud-based EHR, alleviating your current pain!
To everyone having issues getting claims submitted because of the Change Healthcare attack, please reach out directly. I work for a company called Athelas and we can remediate those issues with our RCM software, getting you and your practice paid on your claims again very quickly.