{"id":3173,"date":"2024-09-17T19:24:08","date_gmt":"2024-09-17T19:24:08","guid":{"rendered":"https:\/\/portfolio.abdullahhashmi.dev\/rcm\/?p=3173"},"modified":"2024-09-17T19:40:29","modified_gmt":"2024-09-17T19:40:29","slug":"how-to-recover-from-the-devastating-impacts-of-change-healthcare-cyberattack-what-cms-offers","status":"publish","type":"post","link":"https:\/\/portfolio.abdullahhashmi.dev\/rcm\/how-to-recover-from-the-devastating-impacts-of-change-healthcare-cyberattack-what-cms-offers\/","title":{"rendered":"How to Recover from the Devastating Impacts of Change Healthcare Cyberattack? What CMS Offers?"},"content":{"rendered":"<h2>Overview<\/h2>\n<p>Did you know that providers across the nation are facing a daunting reality after the\u00a0Change Healthcare cyberattack?\u00a0 According to a recent analysis by Kodiak Solutions, claims to payers have dropped by more than one-third. But that\u2019s not all \u2013 with a staggering\u00a0$6.3 billion in delayed payments\u00a0spread across\u00a01,850 hospitals\u00a0and\u00a0250,000 physicians.\u00a0Beyond the immediate financial strain, this attack may also lead to increased claim denials due to delays in filing. Hospitals surveyed by the American Hospital Association reported that\u00a060%\u00a0of them experienced a daily revenue impact of\u00a0$1 million or more. There is a clear need for solutions to help healthcare providers recover from this\u00a0multi-billion dollar\u00a0financial blow and ensure the continued delivery of essential medical services. CMS is actively working on this. Fortunately, there are steps you can take to mitigate the impact of the attack and get back on track:<\/p>\n<h2>Recover Lost Funds: Relief Efforts for Impacted Providers<\/h2>\n<p>The Change Healthcare cyberattack has inflicted a significant financial blow on the healthcare industry. Several government and industry initiatives are stepping up to offer financial assistance to struggling healthcare providers. Here\u2019s a breakdown of the available resources:<\/p>\n<h2>CMS Guidance on Medicaid Flexibilities in Response to Change Healthcare Cyberattack<\/h2>\n<p>Recognizing the disruption caused by the cyberattack, CMS is offering relief to Medicaid providers through a two-pronged approach:<\/p>\n<h3>1. Interim Payments<\/h3>\n<p>On March 15, 2024, CMS issued an informational bulletin outlining a program for states to provide\u00a0interim payments\u00a0to\u00a0Medicaid fee-for-service providers. CMS further adds that interim payments should use the current rates set by the state plan and are limited to the expected use of allowed services based on how often providers have recently used them. It\u2019s important to know that these are not advance payments. Interim payments must be sorted out after things are back to normal. Also, states have to follow all the rules for documentation, including making payments for allowed services that were affected by the\u00a0Change Healthcare cyberattack.<\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li><strong>Purpose:<\/strong>\u00a0This program aims to mitigate the cash flow strain caused by the disruption in claims processing and prevent disruptions in access to care for Medicaid beneficiaries.<\/li>\n<li><strong>State Action Required:<\/strong>\u00a0Individual states need to submit a state plan amendment (SPA) for expedited CMS approval.<\/li>\n<li><strong>The SPA should detail:<\/strong>\u2028A methodology for calculating interim payments based on current state plan rates and historical provider utilization data.\u2028A process for reconciling these interim payments will be established once claims processing functionality is restored.<\/li>\n<li><strong>Timeline for States to Follow:<\/strong>\u00a0States are encouraged to submit SPAs by March 31, 2024, or notify CMS of their intent by April 10, 2024.<\/li>\n<li><strong>Funding:<\/strong>\u00a0States can draw down federal matching funds once a SPA is submitted and approved.\u2028The interim payment methodology can be applied retroactively to the first date of the\u00a0cyberattack disruption\u00a0but must sunset by June 30, 2024.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>2.Benefits for Medicaid Beneficiaries After SPA Approval:<\/h3>\n<p>Uninterrupted Access to Care:\u00a0By ensuring continued financial stability for providers, the SPA program helps prevent disruptions in access to care for Medicaid beneficiaries. Reduced Administrative Burden:\u00a0By expediting the SPA approval process, CMS aims to minimize delays in getting the available financial resources to providers, ultimately benefiting beneficiaries who rely on Medicaid services.<\/p>\n<h3>3.Additional Actions Encouraged by CMS:<\/h3>\n<p>States can temporarily suspend cost-sharing requirements for Medicaid beneficiaries while the SPA approval process is underway. CMS encourages states to work with Medicaid managed care organizations to provide interim payments to providers and implement additional flexibilities like:<\/p>\n<ul>\n<li>1.Suspending or modifying prior authorization requirements.<\/li>\n<li>2.Allowing early prescription refills or extending refill lengths.<\/li>\n<li>3.Suspending out-of-network requirements.<\/li>\n<li>4.Modifying existing cost-sharing requirements to align with changes made to the Medicaid state plan.<\/li>\n<\/ul>\n<h3>4.Important Points for Providers to Take Action On:<\/h3>\n<ul>\n<li>CMS is still finalizing specific application processes and details regarding eligibility criteria and amounts for interim payments. So, providers should stay active and continuously follow CMS updates.<\/li>\n<li>States have some flexibility in designing their interim payment methodologies, and these designs will follow CMS guidelines. All states will design their own methodologies according to the guidelines. Providers may need professional assistance to understand their state\u2019s interim payment plan. They can consult\u00a0medical billing\u00a0companies to get assistance promptly.<\/li>\n<li>While changes to Medicaid managed care programs typically don\u2019t require a SPA, contract amendments might be necessary. Healthcare providers must be informed about these amendments in order to avoid any inconvenience or rejections.<\/li>\n<\/ul>\n<h2>CMS\u2019s Change Healthcare\/Optum Payment Disruption Program:<\/h2>\n<p>For providers impacted by Medicare disruptions, the Centers for Medicare &amp; Medicaid Services (CMS) announced a program offering accelerated and advanced payments. Details and application procedures can be found by contacting your Medicare Administrative Contractor.\u00a0This comprehensive approach aims to ensure uninterrupted patient care during this challenging time. The details for this program are: Part A providers can receive accelerated payments, while Part B suppliers can receive advance payments. Providers and suppliers who qualify can get early payments called CHOPD accelerated and advance payments. These payments can be as much as what they\u2019d typically receive for 30 days of claims. To figure out the average, they look at the total claims paid to the provider or supplier from August 1, 2023, to October 31, 2023, and divide that number by three. The money they get will be taken back from future Medicare claims over 90 days through automatic recoupment. Get the details\u00a0here! While CMS monitors the situation, it is suggested that providers should also explore short-term funding programs offered by other payers. CMS also encourages insurers to offer aid and reminds everyone to check their liability insurance coverage for potential protection.<\/p>\n<h2>HHS &amp; Dol Encouragement Call on UHG<\/h2>\n<p>In a positive development, the Departments of Health and Human Services (HHS) and Labor (DOL) pressured UnitedHealth Group, owner of Change Healthcare, to expedite payments to providers impacted by the cyberattack and provide more transparent communication. Additionally, they urged all payers to offer interim payments, reduce administrative burdens, and temporarily suspend prior authorization requirements. The American Hospital Association (AHA) applauds this action and emphasizes the need for all payers to step up financially to ensure this disruption does not compromise continued patient care.<\/p>\n<h2>Optum\u2019s Emergency Funding<\/h2>\n<p>Optum, a subsidiary of UnitedHealth Group, has established an\u00a0emergency funding program\u00a0to help providers in this hour of need. This program offers\u00a0cost-free loans\u00a0to affected providers. While the total funds available are not publicly known, and the loan amounts might not fully cover the provider\u2019s expenses, they serve as a crucial resource, particularly for smaller practices. For more information and application details, visit the Optum\u00a0website\u00a0and process your loan.<\/p>\n<h2>Potential Support from Other Payers<\/h2>\n<p>Following HHS\u2019s call to action, other private payers might also consider offering similar advance payment programs to their contracted providers. Stay updated with your payers\u2019 communication channels for any announcements regarding financial assistance options.<br \/>\n<strong> Things to Remember:<\/strong><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>While these programs offer much-needed support, it\u2019s crucial to gather all the necessary information before applying and checking your eligibility for the open programs. This may include details about your practice\u2019s financial situation and documentation related to affected claims. The\u00a0revenue cycle\u00a0experts at Integrity RCM can help you gather these detailed reports about your practice\u2019s financial situation and help verify your eligibility.<\/li>\n<li>Explore all available options. Don\u2019t limit yourself to a single program.<\/li>\n<li>Act promptly. The sooner you apply for assistance, the quicker you can receive the financial resources needed to maintain operations during this challenging time.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>By leveraging these resources and remaining proactive in seeking financial support, healthcare providers can navigate the current disruption and continue delivering essential services to their patients.<\/p>\n<h2>What Other Ways Can You Choose to Recover Your Loss?<\/h2>\n<p>While Change Healthcare recovers from the cyberattack, here are some alternative ways to submit claims that might be impacted:<\/p>\n<h3>1. Direct Payer Submission:<\/h3>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>Contact each payer you submit claims to directly.<\/li>\n<li>Inquire about alternative submission methods they might be offering during this disruption. Some payers may accept claims through:<\/li>\n<li>1.Their online portals (if available)<\/li>\n<li>2. Secure email channels<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>2. Clearinghouse Alternatives:<\/h3>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>Consider using alternative clearinghouses to submit claims electronically.<\/li>\n<li>Research reputable clearinghouses that are not affiliated with Change Healthcare.<\/li>\n<li>Ensure the chosen clearinghouse has established connections with your payers for smooth claim routing.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>3. Contact Your State Medicaid Agency:<\/h3>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>If you\u2019re a Medicaid provider, contact your state Medicaid agency for guidance.<\/li>\n<li>They might have implemented alternative claim submission processes specifically for the Change Healthcare disruption.<\/li>\n<li>Explore alternative channels for submitting claims not yet processed by Change Healthcare.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong> Important Note:<\/strong><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>Before submitting claims through any alternative method, confirm the process with your specific payers to ensure they\u2019re accepting submissions through that channel. Get help from professional billers like those at Integrity RCM to get details about all USA payer policies.<\/li>\n<li>Keep detailed records of all communication with payers and any alternative claim submission attempts during this time. This documentation will be helpful if there are any issues with claim processing later.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2>Integrity RCM\u2019s Assistance \u2013 The Pro-Active Approach to the Recovery of Your Lost Cash Flow!<\/h2>\n<p>Approach result-driven medical billing companies in the USA like\u00a0Integrity RCM,\u00a0which is one of the best among the rest. This is because billing companies can be crucial allies for providers navigating the financial challenges caused by the\u00a0Change Healthcare cyberattack.\u00a0Here\u2019s how Integrity RCM can offer significant support:<br \/>\nImmediate Relief<\/p>\n<h3>Assistance in Alternative Claim Submission:<\/h3>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>We can help identify and implement alternative claim submission methods for providers.<\/li>\n<li>Our\u00a0certified 1100+ medical billers\u00a0can assist with setting up online portals, secure email channels, or partnerships with alternative clearinghouses.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>Advance Reconciliation:<\/h3>\n<p>Our\u00a0medical billing company\u00a0can begin preliminary reconciliation of claims even before Change Healthcare restores full functionality. This can help identify potential issues and expedite processing once the system is back online.<\/p>\n<p>Long-Term Support<\/p>\n<h3>Cash Flow Management:<\/h3>\n<p>Our experts can help providers with short-term cash flow management strategies. This could involve analyzing historical data to forecast upcoming revenue and expenses. Additionally, we can assist with applications for financial relief programs offered by CMS, private payers, or Optum.<\/p>\n<h3>Coding and Documentation Review:<\/h3>\n<p>By ensuring accurate coding and complete documentation on claims, we can minimize\u00a0denials\u00a0and maximize reimbursements. This becomes even more critical during a time of potential delays like in the current cyber attack situation.<\/p>\n<h3>Negotiating with Payers<\/h3>\n<p>Our experts can leverage their expertise to negotiate more favorable payment terms with payers. This could involve securing faster payment cycles or reducing administrative burdens.<\/p>\n<h3>Data Security and Risk Management:<\/h3>\n<p>Our professionals can offer guidance on data security best practices and risk mitigation strategies to help providers minimize the impact of future cyberattacks.<\/p>\n<h3>Proactive Follow-Up:<\/h3>\n<p>We can play a crucial role in following up with payers on behalf of providers to determine the status of stuck claims.<br \/>\nIntegrity RCM can act as a safety net for providers during this challenging time. By offering immediate relief through alternative claim submission and cash flow management and providing long-term support with coding and negotiation, we can help providers maintain financial stability and continue delivering essential care to patients.<\/p>\n<h2>Get Integrity RCM\u2019s Assistance to Revive Your AR After Change Healthcare System Restoration!<\/h2>\n<p>As Change Healthcare\u2019s systems recover from the cyberattack, your top priority will be to reclaim your accounts receivable. Integrity RCM\u2019s AR experts are here to help you recover your stuck claims with our proven expertise. We\u2019ll work tirelessly to recover your accounts and get you back on track financially.<br \/>\nOur comprehensive\u00a0AR recovery services\u00a0include:<\/p>\n<ul>\n<li>Denial Management:\u00a0We\u2019ll identify and appeal denied claims, maximizing your reimbursements.<\/li>\n<li>Coding and Documentation Review:\u00a0We\u2019ll ensure your claims are coded accurately and completely, minimizing denials and delays.<\/li>\n<li>Payer Negotiations:\u00a0We\u2019ll leverage our expertise to negotiate favorable payment terms with payers, expediting cash flow.<\/li>\n<li>Patient Collections:\u00a0We\u2019ll handle patient collections efficiently and respectfully, preserving your patient relationships.<\/li>\n<\/ul>\n<p>With Integrity RCM\u2019s help, you can recover your AR quickly and efficiently, minimizing the financial impact of the Change Healthcare cyberattack.<\/p>\n<h2>To Sum It Up<\/h2>\n<p>In the end, the Change Healthcare cyberattack\u2019s impact is undeniable, but you\u2019re not alone. Relief programs from CMS, HHS, and your payers can help ease the financial burden. So, keep following the websites of government agencies and your payers to get updates and information about the recently announced relief programs. On the other hand, to keep your side double safe, explore alternative claim submission methods and consider partnering with a billing company like Integrity RCM for additional support. Proactive action and available resources can help you recover and keep delivering essential care. Don\u2019t let this cyberattack cripple your healthcare practice.\u00a0Contact Integrity RCM today, and let us help you recover and move forward. Our experienced team will work closely with you to develop a customized plan to address your specific needs.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Overview Did you know that providers across the nation are facing a daunting reality after the\u00a0Change Healthcare cyberattack?\u00a0 According to a recent analysis by Kodiak Solutions, claims to payers have dropped by more than one-third. But that\u2019s not all \u2013 with a staggering\u00a0$6.3 billion in delayed payments\u00a0spread across\u00a01,850 hospitals\u00a0and\u00a0250,000 physicians.\u00a0Beyond the immediate financial strain, this [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":3190,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3173","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"acf":[],"_links":{"self":[{"href":"https:\/\/portfolio.abdullahhashmi.dev\/rcm\/wp-json\/wp\/v2\/posts\/3173","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/portfolio.abdullahhashmi.dev\/rcm\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/portfolio.abdullahhashmi.dev\/rcm\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/portfolio.abdullahhashmi.dev\/rcm\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/portfolio.abdullahhashmi.dev\/rcm\/wp-json\/wp\/v2\/comments?post=3173"}],"version-history":[{"count":5,"href":"https:\/\/portfolio.abdullahhashmi.dev\/rcm\/wp-json\/wp\/v2\/posts\/3173\/revisions"}],"predecessor-version":[{"id":3197,"href":"https:\/\/portfolio.abdullahhashmi.dev\/rcm\/wp-json\/wp\/v2\/posts\/3173\/revisions\/3197"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/portfolio.abdullahhashmi.dev\/rcm\/wp-json\/wp\/v2\/media\/3190"}],"wp:attachment":[{"href":"https:\/\/portfolio.abdullahhashmi.dev\/rcm\/wp-json\/wp\/v2\/media?parent=3173"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/portfolio.abdullahhashmi.dev\/rcm\/wp-json\/wp\/v2\/categories?post=3173"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/portfolio.abdullahhashmi.dev\/rcm\/wp-json\/wp\/v2\/tags?post=3173"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}