Change Healthcare Outage Update

By TherapyNotes, LLC on April 2, 2024

Status Updates on Change Healthcare Outage

Update 4/4/24 at 1:10 PM ET:

We are not adding additional updates to this page.

For the most up-to-date information, please visit Clearinghouse Services Status. 

Update 4/3/24 at 4:25 PM ET

We have added an additional 48 payers to the Supported Payers List. You can view those here:

https://blog.therapynotes.com/supported-payers-for-claims-with-claim.md

 

Update 4/3/24 at 2:25 PM ET

As noted previously, we are automatically resubmitting iEDI claims that got rejected. This is causing two issues. Users may see a rejection count in their to-do list, but no rejections to process. The issue has been addressed so it won't get worse, and a script is being written to fix this for all users where it is already a wrong count. Second, users are seeing that they have claims to submit, even though we already resubmitted them. We are going to address these items so they are no longer showing as needing to be submitted. The user should not resubmit them. If they do, it's not a big deal and they'll just get a duplicate claim rejection. Until that issue is resolved we have stopped resubmitting iEDI rejected claims automatically.

Update 4/3/24 at 9:30 AM ET

We have added an additional 74 payers to the Supported Payers List. You can view those here:

https://blog.therapynotes.com/supported-payers-for-claims-with-claim.md

 

Update 4/2/24 at 6:50 PM ET

Billing Status Update

  1. We are caught up on sending out claims. Claims won't ever be stuck in "Pending" very long before they are picked up and submitted to the clearinghouse.
  2. Claim status updates from the clearinghouse are on a bit of a delay, but are getting caught up quickly now as we have dramatically sped up this process. We are still parsing files from iEDI and we are about 1 day behind on CLAIM.MD. This will get caught up closer to real-time very soon.
  3. We are working on supporting claim and payer enrollments as our top priority. Claims is an overall higher priority but the effort to do both overlaps and ERA is a subset of the effort to do claims. Therefore we'll likely have ERA enrollment done first. We hope to share a rough timeline soon!
  4. The blog update yesterday said we were not confident that we will ever receive ERAs from Change Healthcare. This comment was driven by pessimism given the unsatisfactory update from Optum, but we are still hopeful that they are going to have ERAs for us when their services come online. (Or maybe we will find that our pessimism was founded.)
  5. We are now automatically resending claims rejected by iEDI to CLAIM.MD, within 5 minutes of the rejection notification coming to us.
  6. Soon we are going to resubmit all claims stuck at "Submitted" that were sent to Change Healthcare at the beginning of their outage.
  7. We have about 100 more obscure payers to add to the supported payer list that we will add very soon. All of these payers have less than 500 claims queued in total.
  8. A few payers that required enrollment in Change but do not require enrollment in CLAIM.MD will now work. This only applies to new practices that didn't already complete the enrollment in TherapyNotes.
  9. Some claims are being rejected from CLAIM.MD saying "Claim Status A3". These were rejected but the actual reason is not being properly displayed. We are looking into this with urgency.
Common questions of the day!
  1. If a claim says "Submitted" it means we sent your claim successfully to the clearinghouse. This happens immediately. We then get back response files that say if it was forwarded to the payer or rejected. Processing these files takes a while, so it's possible a claim was already sent to the payer or rejected and it doesn't reflect that yet in TherapyNotes. A claim that says "Pending" means we will send it as soon as we are able. Claims for payers that require enrollment will be stuck like this for now. If you submit a new claim you may see it say "Pending" for a couple minutes before it gets sent. We previously had an issue that iEDI claims that were sent still said "Pending" but that was resolved.
  2. What is enrollment? Some payers require you to complete paperwork in order to send claims from a new clearinghouse. Others don't require this. Because we haven't completed the enrollment process yet, we are not able to send claims to payers that require enrollment. (We could, but they would get rejected.) ERA enrollment is required by all payers because that's how you tell them where to send your ERA files. In either case there is nothing you should do to enroll in claims or ERA until we enable enrollment features.
  3. What about my CLAIM.MD account? TherapyNotes is contracted with CLAIM.MD so you will not need a CLAIM.MD subscription, similar to how you didn't need a Change Healthcare account. If you are currently using them to send claims for payers we don't support then it would make sense to maintain that account. However, if we are now sending all your claims for you, you may not need CLAIM.MD anymore.

 

Update 4/2/24 at 8:35 AM ET

All claims sent through iEDI that were rejected so far have been queued to be resubmitted using CLAIM.MD. They have been reset back to “Pending”. As discussed in the previous update, iEDI resulted in more rejections than usual because they didn’t do claim edits for common issues. This was particularly problematic with Aetna. Claims are flowing very quickly through CLAIM.MD so expect them all to go out quickly. Because we are still processing claim updates we may see more rejection responses, so we will continue to requeue additional rejections from iEDI as they come in. If you see a rejection from iEDI you do not need to take any action for it to be resent.

 

Update 4/1/24 at 5:45 PM ET

Here is a summary of updates related to recovering clearinghouse services.

  1. We had our Change Healthcare conference call today to discuss bringing Change Healthcare services back online. The news was bleak for the services that apply to us. At this time they are asking everyone to move to yet another clearinghouse that they own. Unfortunately we have very little confidence we will ever see any ERAs for past claims that were submitted to Change Healthcare. At this time we don’t anticipate utilizing any Change Healthcare services moving forward, including Optum iEDI or Change's eligibility services
  2. One of our top priorities now is to support ERA enrollments. We are testing a short-term solution to onboard practices quickly for ERAs so we can ensure everything is working as expected and get the ball rolling, and we are working on a more complete solution in TherapyNotes. We completed the work to accept ERAs from CLAIM.MD, so now we just need to get you all enrolled! Claim enrollments are also being worked on, and all the efforts to support ERA enrollment overlaps with claim enrollments.
  3. Today 140 more payers have been added to the our supported payer list for electronic claims, for a total of 1,133 payers. We are now sending out claims to almost all payers that don’t require enrollment that concern our customers. We will continue to add more payers over the next few days.
  4. Claims sent will now go from Pending to Submitted much more quickly, likely in just a couple hours. This is because we are caught up on our massive backlog of claims. This occurs every few hours because we are currently manually queueing these up. Very soon we will get this back to just minutes , like it used to be.
  5. As previously noted, claims submitted by iEDI may say “Submitted” even though they were already sent to the payer and we just haven’t processed the response file yet. We are still chugging through several days worth of response files but we are working on a few solutions to dramatically speed up this process. At this point if you haven’t seen an iEDI-sent claim in a payer portal it was probably rejected. You can manually resubmit the claim to force it to CLAIM.MD if desired, however see our next update…
  6. We are going to resend all claims that were rejected by iEDI to CLAIM.MD. Because iEDI did not do claim edits for common issues, many claims were rejected. You do not need to take any action. We intend to do this in the next day or so, and continue to do so as we detect more rejections, as we parse our backlog of response files.
  7. We are also going to take a look at all claims that were sent to Change Healthcare around the time of the outage, but never got a response. We will likely resend these to CLAIM.MD as well. You can proactively resubmit these if desired. We will provide additional details when we have made a determination on our game plan.
  8. In order to help providers manage the impact of the attack against Change Healthcare, the U.S. Department of Health and Human Services (HHS) has compiled information, resources, and tools from health plans and payers for providers in need of assistance. In this document, providers will find information to help them connect with payers regarding impacts of the cyberattack, links to resources payers have set up (including guides to connect to alternate data clearinghouse services), information on advanced payments, and more. https://healthsectorcouncil.org/wp-content/uploads/2024/03/HHS-Letter-and-Appendix-to-HC-Providers-1.pdf
Thank you to our customers for your continued patience. Also, thank you to the development teams working so hard to tackle all of this from every possible angle, even through a holiday weekend, and to the support staff that are working so hard to assist our customers through this as best they can.
 
Update 3/29/24 at 5:55 PM ET

Here is a list of all payers to which we are currently sending out electronic claims. This list will be updated regularly with additional payers.

https://blog.therapynotes.com/supported-payers-for-claims-with-claim.md

Update 3/29/24 at 3:50 PM ET

We are now only sending claims to CLAIM.MD! We are ramping it up slowly over the weekend to make sure there aren't major concerns and then we will open the floodgates so that all claims to all payers that don't require enrollment will be going out!

Practices are experiencing unexpected rejections for claims sent to iEDI. This is because Change Healthcare automatically did claim edits to correct for common issues, which iEDI does not do. The most common example seems to be that Aetna doesn’t like if member id has a space. CLAIM.MD will bring back the functionality of automatically correcting issues like these.

If you take no action, and leave these claims in the “Rejected” (or “Rejected - NEW”) state, we will automatically resend these claims to Claim.MD, where we are expecting much better results and faster turnaround times. Our target is to do that early this coming week.

In other news, we have a meeting on Monday afternoon with Optum to discuss the resumption of Change Healthcare services. We may utilize them to send claims that require enrollment, to get out claims ASAP, and we are hopeful they will be able to send us a backlog of ERA files. We will include any news in our Monday update.

We are working on a payer list to clarify exactly which payers we are sending to.

Update 3/28/24 at 6:45 PM ET

We have a lot of important updates to share today regarding our efforts to resume full clearinghouse functionality. Please read carefully.

New Clearinghouse Provider: CLAIM.MD

We are happy to announce that TherapyNotes has selected CLAIM.MD to be our new clearinghouse. A big factor in this decision was the success that our customers were experiencing when working with them directly, as shared in our Facebook community. Although we just signed agreements today, we have been working on this transition for a while now.

The transition of sending claims to CLAIM.MD will start tomorrow, with the goal of being fully live in the next couple days. We do not need to go through the slow testing process per payer because CLAIM.MD provides the automatic claim edits that were provided by Change Healthcare. So payers like Cigna that got caught up in the testing phase with iEDI will be able to start getting submitted promptly.

During the transition to CLAIM.MD we will also continue to send claims to iEDI, taking advantage of our new support for multiple clearinghouses.

For payers that require enrollment, there is still work to do. We have to update our payer list in TherapyNotes to use the CLAIM.MD payer list and payer IDs, and update how we track enrollments. But one of the reasons we chose CLAIM.MD is their automated system to streamline enrollments. We are working on making that available in TherapyNotes as soon as possible. We are also looking into short-term solutions and we will advise as soon as we have more information to share.

Pending the ability to get practices enrolled in ERA, we have completed the project to accept ERA files from CLAIM.MD. We will continue to concurrently support receiving ERA files from Change Healthcare, for when they restore services. ERA enrollment is now a top priority.

iEDI Updates

As a reminder, iEDI is the clearinghouse that Optum made available to us as a workaround while they were working to restore Change Healthcare’s services. We were able to use this solution to send out the majority of our backlog of claims. We recognize this only aided practices that submit to specific payers, but for those that it did help, it was a huge benefit.

We have an updated payer list that shows a few more payers that have passed testing and now have claims going out, but given our imminent transition to CLAIM.MD this list will only apply for a little while longer. (Again, with CLAIM.MD we will be sending claims for any payer that doesn't require enrollment without a testing process for each payer.)

https://blog.therapynotes.com/payers-being-submitted-through-iedi

We are happy to report that we are now processing response files from iEDI which means you will see more detailed status updates besides just “Submitted”, similar to what you were used to with Change Healthcare. Unfortunately these updates are taking a very long time to process since there are responses for hundreds of thousands of claims. It may take over a week for all of these to be updated. In many cases you'll already have posted the payment before this update comes in.

Here are the claim statuses you may see:

  • Pending - The practice submitted the claim and we will send it if we can. (For payers that require enrollment it will stay in this status for now.)
  • Submitted - We have sent the claim to the clearinghouse.
  • Sent - The claim has been sent from the clearinghouse to the payer.
  • Resubmitted - The practice has submitted a claim to the clearinghouse that has already been submitted at least once.
  • Canceled - The claim won’t be sent to the clearinghouse, for example if you submitted the claim externally.
  • Rejected - Either the clearinghouse or the payer has rejected the claim.
  • Paid - Your practice has entered or allocated an insurance payment into TherapyNotes for the claim.

The Pending, Submitted, Canceled, and Paid statuses will display as soon as the claim transitions to that state in TherapyNotes. However, the other statuses depend on a response from the clearinghouse and will have a delay from when that transition occurred. Usually these changes take an hour or so, but we are backed up on processing these files for iEDI. Until then, your payer portals are the best place to see up-to-date statuses.

Help Center Article: Electronic Claim History: Claim Status and Rejected Claims

Because we are now updating the status of hundreds of thousands of claims, any claims that were rejected will be updated to say so. If you have questions about claim rejections please email us so that we can investigate. Please do not call us about claim rejections so that we don’t overload our support staff. Here is an article of common reasons for claim rejections, so that you can address the issue and try again.

Help Center Article: Reading a Claim Rejection

Change Healthcare Updates

Change Healthcare indicated that realtime eligibility will be taken back online next week, so that gives us some hope that other services will follow. We will turn this service back on but only if it does not take away focus from other more important projects. Ultimately we will be transitioning to CLAIM.MD’s eligibility services.

There have been no new updates from Change Healthcare regarding re-enabling claims services that apply to TherapyNotes customers. If claims processing comes back online before we are ready to support those payers in CLAIM.MD, we will send those claims to Change to get them out as quickly as possible. This would be especially useful for Medicare/Medicaid claims since those enrollments take longer.

There also have been no updates regarding ERA services. We are hopeful they will restore services soon and send us the ERAs that have been queued up by the payers over the past several weeks. As noted above, we are going to accept ERAs from Change Healthcare and CLAIM.MD concurrently, for as long as needed.

As always, thank you for your patience. We are continuing to tackle this from every possible angle.

Update 3/26/24 at 3:35 PM ET

We are pleased to share we are continuing to make significant progress for claim submissions to payers that do not require enrollment, including more than doubling our list of payers we’re submitting in the last 24 hours! Our top priority remains getting your claims submitted as quickly as possible. We are still actively testing payers and moving those with successful results to fully submitting through iEDI.

Please continue to check the following page for the latest payer submission information, as we are updating it often while our efforts continue: 
https://blog.therapynotes.com/payers-being-submitted-through-iedi 

At this time, testing is taking longer than we originally anticipated, as the turnaround times from iEDI have slowed due to volume. We want to assure you that we are continuing to expand our testing efforts and have sent new test claims for another large set of additional payers today.

If we have indicated a payer is being submitted to iEDI, we will be submitting claims to this payer on your behalf and encourage you not to manually submit the claim through other clearinghouses to lower the risk of duplicates. In the event you see duplicate claims within your payer portal, you can expect to receive duplicate claim rejections but this will not impact the processing or payment of the original claim.

Any claims already submitted on your behalf will start with a status of “Submitted” to indicate we have sent the claim to the clearinghouse. Additional status changes to these claims, including any rejections, will slowly update as we receive more information from iEDI.

We expect to receive a large number of updates at a time, including rejection details. Please email support@therapynotes.com with any questions regarding rejections you receive.

We appreciate your continued patience.

Update 3/25/24 at 7:25 PM ET

Claims that we submitted for you are now properly showing up as “Submitted” instead of “Pending”.

Update 3/25/24 at 1:50 PM ET

We are happy to report that we are almost caught up sending out all claims for payers that don’t require enrollment. We have now sent out most of the claims for the payers we have confirmed are working successfully, including United, Aetna, and many more.

Important: Sent claims are still showing as Pending.

Due to an unexpected limitation in working with iEDI, the claim status is not going to be updated in TherapyNotes for several more days. Claims will show as “Pending” even if they were sent. We are working to resolve this asap. However you can check your payer portals to see if claims were received and hopefully you will start receiving payments soon. It’s possible many of your claims were sent almost a week ago!

Therefore we do not recommend sending any claims outside of TherapyNotes for the payers for which we have identified are already being sent, as they likely have been sent. We are looking for ways to make this more clear in TherapyNotes.

We are still testing more payers and adding their claims to the queue. Claims are still going out as fast as iEDI can take them. We will update the payer list soon based on testing results that occurred over the weekend. We will have finished testing all payers, make adjustments as needed to those payers, and have sent all applicable claims very soon.

Early on in this process we realized we needed to test each payer individually, as they were not all accepting our claims as-is. By doing some tests, and verifying their results, we are able address these issues on our end and then try again.  This ensures your claims go through efficiently, with less work on your end to clean up and resend rejected claims. For example we learned that we need to make some adjustments for Cigna that would have caused all Cigna claims to be rejected, which we will address in the next day or so.

We are getting a lot of questions asking about specific payers, such as some that were not mentioned in the iEDI payer list. We will look at every single claim that has not gone out and ensure that it is accounted for. The payer list will be updated later today, as we have completed testing for many additional payers.

Change Healthcare is trying to work with Medicare/Medicaid payers that require enrollment to allow practices enrolled through Change Healthcare to send claims through iEDI without a new enrollment. If this occurs we will test and send these claims ASAP.

In order to send claims to payers that require enrollment we will either need to wait for our new clearinghouse partner to be ready or for Change Healthcare needs to come back online - which ever is ready first.

Similarly, for ERAs we will need Change to come back online to receive past ERAs, and we will implement ERA support with the new clearinghouse ASAP so we can start switching your enrollments there. We will support receiving ERAs from both clearinghouses for as long as needed. We are also considering ways to block duplicate ERAs because so many of you have been manually uploading them.

Thank you for your continued patience. We hope you will start getting some payments soon!

 

Update 3/22/24 at 3:00 PM ET

We are happy to report continued success with iEDI and claim submission! Our priority is getting your claims submitted as quickly as possible. We wanted to offer a detailed update on where we are in this process.

Please follow this link for continual updates on which payers we are submitting to iEDI electronically and which payers are in testing to be submitted soon: 

https://blog.therapynotes.com/payers-being-submitted-through-iedi

 

For payers that are being submitted through iEDI:

If the payer is provided on the list for submission, we are submitting queued claims electronically on your behalf and will update claim status appropriately. We recommend you do not download the claim file from the external submission page for these payers to help eliminate the possibility of duplicate claim submission.

Please continue to check your payer portal(s) for more detailed information on the status of a claim and for available Remittance Advice (ERAs) at this time.

For payers that are in testing through iEDI:

We are working diligently to make sure the payers with the highest volume of claims go through testing first. In each round of testing we assure that claims make it to the payer and determine a percentage of rejections. As we gain confidence in acceptance by the payer, we will move the payer from the testing section and into the submitted section.

Thank you for your continued patience and support while we navigate this challenging time. We will continue to provide updates on our efforts and will continue to do everything we can to get your claims submitted. 

 

Update 3/20/24 at 2:50 PM ET

The following list indicates which payers currently do or don't require enrollment in order to send claims with the Optum iEDI clearinghouse.
https://blog.therapynotes.com/payers-being-submitted-through-iedi

Update 3/20/24 at 2:00 PM ET

We are happy to report that our test claims sent yesterday through iEDI were successful! The claims appeared in the payer portal shortly after we sent them. Today we are expanding our testing to send many more claims for practices we are working with closely. Our goal is to be automatically sending all claims for payers that don't require enrollment by the end of this week! We are also enhancing our software to make this process entirely seamless for you, so it's clear which payers don't require manual effort.

For the payers we cannot submit electronically, you'll still see the button to do so manually, if you do not want to wait. There will not be a button to download claims for items we submitted. It will be really easy to identify the ones that need to be sent manually.

We are prioritizing the project to automate payer enrollments so that when we switch to the new clearinghouse, we can get you up and running quickly and we can get your claims out. Enrollment is usually a trivial process. We don't have a timeline to share yet, but it's now our top priority.

Some recent questions we have been seeing:

What payers require enrollment to send claims? Most payers do not. If the payer didn't require enrollment with Change Healthcare, they most likely do not require enrollment with other clearinghouses such as iEDI or the new clearinghouse. Some BCBS payers require enrollment, but not all of them. We will provide a comprehensive payer list soon.

Does it matter if I'm in or out of network with a payer? Whether or not you are in or out of network with a payer has no bearing on our ability to send claims or enrollment, or whether or not enrollment is required.

Should I wait for TherapyNotes to send claims or do it myself? Our goal is to get out all claims you've submitted as soon as possible, so if you want to wait, we'll take care of it for you. But if you want to submit them right away, that continues to be up to you. Use the information we've provided to help you make this decision. We will update this status page with timely updates so you know when you should stop sending claims that we're going to send out for you.

Update 3/19/24 at 9:00 PM ET

Optum previously reported that they would begin turning on and rolling out Change Healthcare services through this week - the week of 3/18. We expected we would be fully operational by the end of the week. However, as they described the rollout schedule of the various services, and how we fit into that schedule, we realized that we may still be a couple weeks away from being able to resume services, which of course is entirely unacceptable.

Over the past several weeks we have been preparing to support alternate clearinghouses, in the case Change Healthcare could not restore services in a timely manner, and we are now ready to start sending claims through another clearinghouse.

We have been working with Optum and their iEDI clearinghouse as a means to send claims, and this afternoon we sent a few test claims. We are now waiting for confirmation from the payer that these were received successfully. We will continue to send out claims tomorrow, and as we gain confidence everything is working, we will start sending out all queued up claims for payers that don't require enrollment, with the goal of having them all sent by the end of the week.

We will not be sending claims to payers that require enrollment to iEDI in this first round. Optum is working with payers, such as government and BCBS, to support dual enrollment so you don’t need to reenroll. As Optum gives us the go-ahead we will send claims for these additional payers.

All that being said, we have made the decision to switch to a new clearinghouse, something we have been preparing for from the beginning. Because we haven’t signed the final agreements yet, we can’t announce who it is, but we have been impressed with their services. We have confidence we can switch quickly and we will share a more specific timeline when we are able.

The primary benefit of the new clearinghouse over iEDI is that we will be able to send claims to the payers that require enrollment. Unfortunately, practices will need to re-enroll with all payers to send claims, but we are going to provide a streamlined process.

Of course if Change Healthcare comes back online before this work is done, we can make the decision to send claims out for these payers. Yes, it’s hard to keep up with all these moving parts and possible paths, but because our software now supports multiple clearinghouses we have more flexibility to make decisions as we get more information.

The Mark External Claims page will continue to show the claim file download button for any claims that we aren’t sending, so you will be able to focus on the claims for payers that require enrollment. Alternatively, you can continue to wait for Change Healthcare or the new clearinghouse to be ready, whichever comes first.

Unless you changed anything, regardless of how we send the claims, your ERAs are still going to go to Change Healthcare. This means you won’t be able to receive them until Change restores service. When the new clearinghouse is ready we will work with you to update payer enrollments to send your ERAs there instead. We will be updating our software to receive ERAs from both clearinghouses.

Thank you for your continued patience. We will continue to provide updates as we have information to share.

Update 3/13/24 at 9:00 PM ET

Change Healthcare held an update call this afternoon to provide updates on their progress towards restoration of service. They continue to report they are on target to begin the process next week (beginning on March 18th). An outline was provided for a 3-step process for services coming back online: connection, testing, and resumption. In the connection phase, the rebuilt infrastructure will be thoroughly tested by a variety of third-party cybersecurity experts (including companies like Mandiant and Palo Alto) to ensure that connections are safe and properly secured. The testing process will then ensure that various transactions will occur effectively and appropriately. The final step will be the resumption of services – insurance companies, EHRs, and other customers will reconnect to Change Healthcare services to begin the flow of information again.

Change Healthcare has acknowledged that some transactions have been delayed during the outage and will work with payers on an individual basis to get claims and ERAs requeued and reprocessed. This may result in receiving duplicate ERAs, or no ERAs – it will depend entirely on each payer how they choose to move forward. Change Healthcare is committing to getting as much volume processed as quickly as possible in order to return to normal operations. Change is anticipating real-time eligibility checks to be restored shortly after claims and ERAs are working again.

Change Healthcare continues to encourage customers to apply for their funding opportunities for an interest-free short-term loan. They continue to expand eligibility and ask anyone impacted by the outage to apply, even if you were previously denied a loan or offered an unusually low amount. The low amounts were due to their automated loan application not accounting for providers that only use Change Healthcare to send claims. Get additional information through the Optum inquiry form.

TherapyNotes is going to automatically cancel all claims that you have indicated you submitted externally or on paper, so we will not be sending those claims to Change Healthcare. Further, if an insurance payment was entered for that claim, we will also cancel the claim. This reduces the noise from duplicate claim rejection errors, and will reduce the volume of claims we will need to send out as we catch up. Please note that generally duplicate claim errors are not a cause for concern.

We’re happy to share that during the Change Healthcare outage TherapyNotes has done a lot of work to support alternate clearinghouses, and we are just about ready to start sending claims to Optum’s iEDI  clearinghouse if needed. If there are any issues with Change Healthcare services resuming in a timely manner next week, we can make the decision to start sending out claims through iEDI.

TherapyNotes will make all electronic claims and ERAs free through the end of April. This will ensure you are not charged for any duplicate claims or ERAs, plus you can catch up on all your billing (and then some) for free.

Thank you for everyone’s patience!


Update 3/8/24 at 5:30 PM ET

On this afternoon’s phone call, Change Healthcare reiterated that claims services will be restored on the week of March 18th.

Change Healthcare announced an expansion of their temporary funding program to providers who have been unable to submit claims and whose payers are not offering advanced payment programs. Providers can apply for interest free funding that will be reviewed on a case-by-case basis. More information on these temporary funding programs can be found at http://www.optum.com/temporaryfunding.

In the meantime, we are continuing to work on our workaround solution as well as connectivity to alternate clearinghouses in case there are further delays and to be better prepared for the future. We are continuing to review Optum's iEDI platform, and have been having discussions with other clearinghouses. We are also preparing our claims and ERA services to be able to handle a much greater volume than usual following services being restored. 

We also created this video to show how to download claims from TherapyNotes and upload them to Office Ally, for those of you who have not yet tackled that and don't want to wait until services are fully restored.
https://www.youtube.com/watch?v=Gx2Oxp4rDb4 


Update 3/7/24 at 8:30 PM ET

Change Healthcare has provided this update:

“We expect to begin testing and reestablish connectivity to our claims network and software on March 18, restoring service through that week.”

https://www.unitedhealthgroup.com/newsroom/2024/2024-03-07-uhg-update-change-healthcare-cyberattack.html

TherapyNotes will continue to support and improve our workaround solutions and we have not ruled out changing vendors long term, but for now our best option is for a restoration of Change Healthcare solutions and return to business as usual. We were just provided this information. More updates to follow.


Update 3/5/24 at 6:00 PM ET

Change Healthcare held another conference call this afternoon to discuss progress in their recovery. They announced most of their e-prescribe network services have been restored, and they will complete end-to-end testing by Thursday.

Change also reported continued progress with payers who used their services as an exclusive gateway – they are transitioning services to a clearinghouse owned by another subsidiary to get claims flowing as quickly as possible. This clearinghouse, known as Optum Intelligent EDI (IEDI), is also being made available to partners like TherapyNotes. Change is working to expand capacity and capability of IEDI to accept claims similarly to how the Change Healthcare clearinghouse services worked. This has the potential to allow us to restore at least some clearinghouse services significantly faster than switching to an entirely new vendor. TherapyNotes is actively working with our Change Healthcare team to explore a transition to IEDI. Additionally, we have multiple teams working tirelessly to find solutions and continue our efforts towards finding other vendor solutions and making files available for upload outside of TherapyNotes as easy as possible. 

On the call, Change Healthcare was explicitly asked to provide a timeline for when they expect a recovery of medical claim submission. Beyond highlighting their efforts at recovering systems and discussing the availability of IEDI, Change Healthcare did not provide any specific information about how much longer they expect services to be down. They did report that the velocity of recovery efforts was accelerating but gave no information on timelines. The next scheduled conference call will be this Friday afternoon 3/8 and we will provide another update as soon as possible.

 


Update 3/1 at 6:30 PM ET

Change Healthcare held another conference call to discuss updates this evening.  They announced a return to operations for their pharmacy  services, but did not provide a timeline for claims, ERAs, or eligibility checks to resume functioning.  They are working with payer partners to find ways to route claims where Change Healthcare was the only available point of contact.  At this time, Change Healthcare is continuing to recommend providers use available workarounds to submit claims and obtain remittance advice.

Change Healthcare also announced a program for providers who are affected by the outage of Change Healthcare's EFT functionality.  To be clear, if you have registered for EFT directly through an unaffected payer this likely does not affect you.  However, if you have an OptumPay account and had been receiving payments through that account until the outage you may be eligible for the funding program.  To see details of this opportunity and check your eligibility, visit www.optum.com/temporaryfunding.  Change Healthcare did not provide many details on this program - see the FAQs on that page for more information.  You will need an OptumPay account to participate.  Change Healthcare recommends you submit an application if you are unsure if you qualify, as they will research and evaluate for you.

Finally, Change announced a new website to follow for status updates: https://www.unitedhealthgroup.com/changehealthcarecyberresponse.  You can continue to check https://status.changehealthcare.com/ and look at the Medical Network section to check the status of claims, remittances, and eligibility functionality.


Update 3/1 at 5:00 PM ET

Our customers have found that Office Ally usually supports our claim files without editing, and we no longer recommend Availity which has not been working with our claim files. We've created this article Submitting Claim Files Through Office Ally to explain how to create an Office Ally account and upload claims.
 
Consider joining the TherapyNotes Facebook Community for support from your peers and our Facebook team.

 


Update 2/29 at 6:00 AM ET
TherapyNotes continues to look for ways to help you through the Change Healthcare outage. Here are some updates and useful information.
  • Today we are releasing a way to download 5010 claim data files so that you can upload them into a separate clearinghouse or a payer portal. Please read the release notes for details.
  • If you usually receive your ERAs in TherapyNotes, it doesn't matter how you send the claim. The ERA is still configured to go to TherapyNotes as far as the payer is concerned. You should receive these when services are operational again. Alternatively you can download ERAs from payer portals and upload them to TherapyNotes.
  • If you submit claims outside of TherapyNotes, be sure to set the Insurance status to Submitted Externally or CMS Printed, and we will cancel the claims before Change Healthcare services are resumed.
  • We caution you that using paper claims are going to be very slow to be processed due to a huge surge. Payers such as Aetna are strongly encouraging providers to not send paper claims. The long delay to process paper claims versus the remaining delay for Change Healthcare to come back online should be considered.
  • You are welcome to queue up claims and we will submit them when services are operational again, if you are able to wait. This is the least amount of work for you at this time, but obviously payments will be delayed.
  • We still do not have a timeline for a return of service. If we had to guess we feel we still have a couple weeks to go. We will let you know when we hear more. We have another conference call scheduled Friday.
  • We continue to look into at all possible options and to provide as much information and transparency as possible.

Update 2/27 at 5:00 PM ET

Change Healthcare provided additional information on a conference call today. Highlights included:

  • Change Healthcare e-prescribe systems have been rebuilt and are in testing.  While TherapyNotes does not use Change Healthcare for e-prescribing, some providers may have experienced issues with pharmacies receiving prescriptions or difficulties with EPCS services related to the Change Healthcare outage.  Those providers can expect a return to normal in the next few days. 
  • Claims, status updates, ERAs, and eligibility checks continue to be non-functional.  Change is prioritizing those who must use their tools, such as TherapyNotes customers, as part of their recovery.  They recognize that it is not easy to find alternatives for claims, and some payers can only receive claims through Change Healthcare. They are working hard to restore those services as soon as possible, but did not provide a timeline for when that may be.
  • Optum is establishing a short-term bridge payment system for providers.  Providers will be able to go to a website to enroll and verify eligibility for the program.  You will be required to have an OptumPay account.  Funding will be provided weekly to eligible providers based on claims history.  Change has indicated that payments will be issued for the duration of the interruption, and that they expect payments will need to be repaid after claims resume normal operations.  Additional information about the program will be provided at some point on Friday, 3/1.
  • TherapyNotes is exploring various alternative solutions, including discussions with other clearinghouses and the ability to manually download claim data files. We will provide more details when we have information to share.
  • If you submit any claims outside of TherapyNotes that you previously attempted to submit through TherapyNotes, please update the appointment status to "Submitted Externally".

 

* The content of this post is intended to serve as general advice and information. It is not to be taken as legal advice and may not account for all rules and regulations in every jurisdiction. For legal advice, please contact an attorney.

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