Patients and practices across the United States have been impacted by the ransomware attack on Change Healthcare that resulted in millions of Americans’ patient data being stolen and suddenly halted the revenue cycle for providers. Vendors like PCC have stepped up to help as independent pediatricians and smaller practices are especially hard hit with interruptions to cash flow. Here are the latest updates from PCC on what we’re doing to help your practice, with additional insights from a new survey published by the American Medical Association (AMA).
A Brief Recap: Change Healthcare Disruption Impacts on Practices
On the world stage, the disruption is a struggle of ransoms and data loss. Change Healthcare’s parent company, UnitedHealth Group (UHG), says they are “working with law enforcement and outside experts to investigate claims posted online to understand the extent of potentially impacted data.”
However, in communities across the country, independent practices and clinicians have been hit especially hard as claims are halted and rerouted through safer adjudication avenues, leaving some with delayed payments and cash flow.
PCC has been working hard to ensure that our clients and independent pediatricians have the resources and support they need during this disruption. In March 2024, we updated you on a previous blog post that our team’s main focus has been on migrating claims submissions to other vendors.
The Impact on Independent Practices
On Wednesday, April 10th, the American Medical Association (AMA) issued a press release that included an “informal” survey of 1,400 respondents self-reporting the impact the Change Healthcare disruption has caused their practices. Significantly, over a thousand respondents were from practices with fewer than 10 physicians. While we encourage you to take a look at the AMA’s survey data, here is a breakdown.
- 77% of respondents are still affected by the Change Healthcare service disruption
- Approximately one-third have not been able to submit claims or obtain ERAs
- About one-third of respondents are using workarounds to submit claims, obtain ERAs, and verify eligibility
- 55% of respondents have had to use personal funds to cover practice expenses
- Service disruptions have caused severe consequences, including lost revenue and even financial inviability
- Practices attempting to switch clearinghouses sometimes face exorbitant fees
- A few practices are taking advantage of advance payment and assistance programs, but issues persist
- Despite the disruption, only 15% of practices have reduced office hours.
It is significant to note that PCC incurs and pays clearinghouse EDI fees on behalf of our clients. The situation for many practices is dire, endangering their continued existence and the quality of patient care. If you are a PCC client struggling financially, please contact your Client Advocate or contact@pcc.com.
April 2024 Updates from PCC
On April 10th, PCC submitted some accumulated claims upon Change Healthcare’s request as a test of their claims processing recovery. While no issues were detected in the submission, PCC will continue to reroute client practice claims. According to PCC’s Jan Blanchard:
“Until Change Healthcare shows signs that they will do more than receive and store these files, with no promise of any proof of their receipt of them, PCC has no changes to recommend to your claim workflow right now. We will keep you posted on our progress with this experiment.”
Here’s what PCC is up to currently:
- 97% of PCC clients’ electronic claims submissions have been routed to payors through non-Change Healthcare channels
- 97% of PCC clients’ real-time eligibility verification is now conducted with payors through non-Change Healthcare channels
- We worked with Change Healthcare to test restoration of the Revenue Performance Advisor (RPA, formerly Capario) ECS gateway. This has been reestablished along with real-time eligibility connections, though reestablished connections with payors are still required for claims to route through Change Healthcare.
- We are strategizing for clients’ ERA payor/provider reenrollment at a future date.
PCC remains vigilant in our efforts to work with Change Healthcare, UHG, the AAP, payors, and other vendors to mitigate the effects on independent pediatricians. We thank you for your continued support in sharing information with one another. We’ll continue to update as circumstances evolve.
Resources for PCC Clients:
Contact PCC Support at support@pcc.com
PCC’s Chip Hart’s blog, where you can find a list of action items for practices to take during the disruption
