Was just looking to see what groups and practices aree planning during this clearinghouse outage as a result of the changehealthcare hack.
Our practice was configured soley with one clearinghouse that being Changehealthcare formerly Emdeon.
I am currently exploring options of having our claims submitted through Availity Essentials we already have account for or Possibly Optum’s Intelligent EDI. I know when we originally started using eCW Emdeon/Changehealthcare and Trizetto were our only choices.
I was hopeful they would have some more communication about possible systems returning online but I have become less confident in this happening in a timely manner.
EDIT:
I reached out to eCW about support for these clearinghouses and got the response: eCW normally charges a configuration fee but we are waiving it this one time due to the Change Healthcare situation. Current timeline is about 10 business days from eCW. They mentioned the only other currently supported Clearinghouses are Waystar and Trizetto.
RCM Workflow - Billing Workflows for Clearinghouse Outage PDF is very basic and not really going to solve everyone’s problems especially if this goes on potentially a few more weeks.
EDIT2: https://www.unitedhealthgroup.com/changehealthcarecyberresponse
Their most recent update seems to describe mostly backend payer gateway flow but looks like they are recommending providers to move to their new EDI option. So an update from eCW on the optum EDI support would be appreciated.
]]>Claims
As workarounds continue to be deployed, our latest data shows 90% of claims are flowing uninterrupted. Fast adoption and implementation of additional solutions by payers and providers could increase claims to 95% sometime next week.While the claims issue is not fully resolved, our goal is total restoration of our systems. We believe full recovery of the medical network will take longer than the pharmacy network. We are encouraging payers and providers experiencing challenges to use the available temporary solutions to get claims flowing again.
For payers exclusive to the Change clearinghouse, we continue to mobilize a new solution to move the Change gateway claims connection to an Optum electronic data interchange (EDI) claims connection. As of March 5, we are implementing this workaround with more than 25 of our large exclusive payers that used the Change managed gateway, and we’re actively working to bring more online every day.
Moving on to providers, we acknowledge there are still a number of providers who are not able to submit claims or receive payment.
Our strong recommendation is for providers and revenue cycle vendors to connect to our EDI option. This will work for the vast majority of providers who cannot submit today. There are some cases where other approaches need to be designed due to connection incompatibility. We regard EDI to be the most expeditious way to help solve this problem. We fully acknowledge that not all functionality will be in place and will create some rework burden, but we are recommending this approach to get claims flowing.
To support these efforts, as of March 5, 2024, we began hosting an ongoing series of webinars on EDI. Our teams are ready to engage and help those payers and providers get claims connections built quickly through this secure and verified platform.
Please connect with your account team if you want to receive support regarding moving to Optum’s EDI claims connections. Click on the client assistance email link in the Quick Links section on the right. Our team will respond regarding your specific situation to connect you to the resources and webinars to learn more about the solution.
As we continue to navigate this issue, we encourage you to execute your continuity plans with clearinghouses and continue to use payer portals for claims submission, status and eligibility.
I’m worried about missing something that’s assigned to an inactivated user. Has anyone come up with a sure way to catch those tasks?
]]>Thanks,
Karen
]]>Thanks, Angie
]]>-go into his patient communication settings and check mark “patient opts out of all communication” - this would only solve removing appt reminders and I sending the patient a direct sms/phone message
-remove his address and phone # in patient info so someone doesn’t inadvertently mail him a letter or call him
-Check mark “don’t send statements” in patient info so he doesn’t get any bills
It’s a lot of steps to do and staff could easily miss them. Am I missing anything? How do others handle this?
Thanks in advance.
]]>I’ve been with my current company using eCW for 15 years. We are currently in v12. Looking to streamline some of our RCM and Denial Management processes with AI, and wondering if anyone is using anything they’d like to recommend. I’ve been waiting to see what the breakout sessions are going to be at this years’ NUC, but nothing announced so far.
Please share!
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