Why the Change Attack Is a Reason to Consider Refreshing Medical Billing Strategies

The Change Healthcare cyber attack has left providers dealing with delayed payments and increased pressures on their revenue cycle. While this is a time of immense challenge, it’s also an opportunity to rethink the position of medical billing companies in revenue cycle management strategies and how outsourcing can be used to minimize future risk. 

To help you make some progress in this area, we’ve put together some updates on the current status. Here are some of our findings.

Recovery from the attack has not been a case of simply waiting for payments. According to the American Medical Association, 85% of physician practices have had to commit additional resources and staff time to complete revenue cycle management tasks. This has undoubtedly had an impact on their medical billing outcomes [1].  

As things stand now, UnitedHealth Group has announced most services have been restored, but the reality is different for physicians. 

• 60% are still dealing with issues verifying patient eligibility
• 75% still have challenges with claim submission
• 79% are unable to receive electronic remittance advice
• 85% continue to deal with disruptions in payments

The practices suffering the most are those with 10 physicians or fewer. AMA president, Jesse M. Ehrenfeld, MD, MPH acknowledges how difficult this has been for providers. 

“The disruption caused by this cyber-attack is causing tremendous financial strain. These survey data show, in stark terms, that practices will close because of this incident, and patients will lose access to their physicians. The one-two punch of compounding Medicare cuts and inability to process claims as a result of this attack is devastating to physician practices that are already struggling to keep their doors open.”

And while this is a pressing problem, it’s only the beginning. Once the dust has settled, providers will need to dedicate resources to restoring revenue cycle operations, reviewing coding, and following up on submitted claims. Many practices should likely consider outsourcing and working with a medical billing company to get themselves back to an optimal state of revenue cycle health.

While many larger providers are recovering, others still need support. These include small rural safety net providers who need cash assistance. While Change has made efforts to rectify the impact on all providers, the full long-term financial impact is still up in the air – U.S. officials report that they still do not have data as to the extent of the impact [2]. 

What we do know is that billions of dollars in payments were interrupted because of the hack. For providers of all sizes, this has meant an interruption in people getting their prescriptions filled and an impediment for doctors simply trying to run their practices and maintain healthy medical billing standards. There is a stunning example of a Colorado woman who had to pay $1,600 out of pocket for Paxlovid because medical billing functions were down. There’s also the story of the CFO of Oregon Oncology Specialists where cash flow dropped by 50% immediately following the attack. 

For cases like these, getting medical billing and working with competent medical billing companies will be critical – not only to keeping doors open, but to ensure practice recovery and long-term health.

But some providers are looking forward, trying to understand how the long-term repercussions will play out in medical billing [3]. 

Forward-thinking providers are looking to manage risk in new ways. Long-term care provider, RiverSpring Living, for example, is considering splitting medical billing submissions across multiple vendors. While this might create more management challenges and increased burden of coordination, they like the idea of having an alternative vendor on deck in case there are future issues. 

But the biggest question, and the one that is just beginning to be answered, is around the additional cost of untangling the confusion of extra processing and paperwork that will emerge because of the massive backlog in delays. Included in this is the question of denial management. While most providers understand the normal rhythms of their denials and have built their medical billing operations around it, it’s almost impossible to predict what will come after an unprecedented event like this. 

These questions have led many providers to reassess their medical billing office budgets to account for extra pay, temps, and even possibly outsourcing to support the recovery period. And while much is still up in the air, one thing is for sure – efficiency, accuracy, and security will be critical, and good vendor relationships will be central to this kind of recovery. 

As you look to reevaluate your medical billing strategy and where medical billing companies fit in your future of revenue cycle management health, we invite you to contact us today to explore how we can support an even brighter future of revenue cycle security for you and the patients you serve.