Change Healthcare Breach Billing Problems? We’re Here to Help

Providers and patients are frustrated when prescriptions or medical procedures are not provided as needed. This frustration could be a reality for about one-third of Americans whose healthcare providers have been impacted by the recent Change Healthcare breach.

A cyber gang infiltrated the healthcare tech company’s system using compromised credentials and deployed ransomware. This group accomplished the intrusion because the security protocol (multi-factor authentication) meant to prevent remote access wasn’t activated. 

In a show of solidarity, 1st Providers Choice, a leading billing software provider, has joined forces with revenue cycle specialist, Availity. Together, we are providing nationwide support to healthcare providers in processing their healthcare billing transactions safely. This collaborative effort is a testament to the industry’s resilience and commitment to ensuring uninterrupted healthcare services.

Consequences for Healthcare Providers and Patients

Physicians and hospitals that rely on Change Healthcare for billing processes have faced many issues since the cyberattack on the company. These issues range from processing claims and billing patients to verifying insurance coverage. 

The inability to check eligibility has hindered many practices, preventing them from proceeding to the next step of providing medical care, such as ordering lab tests, prescribing medication, or performing medical procedures.  

Furthermore, the breach’s impacts have been far-reaching and continue to affect practices, particularly small-sized or rural practices. The breach has weakened cash flow, forcing practices to reach for their funds or risk not paying their staff, buying supplies, or even going bankrupt.  

On a larger scale, the cyberattack has also affected patient loyalty and public trust. Practices and payers will now face increased scrutiny from the public and regulatory bodies, particularly about their cybersecurity protocols. 

Fortunately, Availity and 1st Providers Choice are ready to support affected clinics. If you are affected by the breach and need help with medical billing, please call 480-782-1116 today to learn more about our integrated medical billing solution.

Understanding Your Practice’s Exposure

Several healthcare providers have experienced issues due to the cyberattack, including losing Electronic Remittance Advice (ERA) or 835 files when Change Healthcare terminated multiple services. 

Some providers have attempted to reconnect with the tech company’s platform using a different mechanism, but they must now reenroll with the corresponding government payers. 

According to an AMA survey of over 1,400 providers, cyber incidents have significantly impacted healthcare providers. A majority of providers (80%) reported losing revenue due to unpaid claims, while 78% experienced lost revenue from claims they could not submit. Additionally, 39% of providers were unable to obtain ERA. 

Rapid Response Plan for Providers Affected by Breach Incidents

Availity platform users prefer 1st Providers Choice as their strategic billing software vendor. With 40 years of experience, our integrated billing solution streamlines billing transactions during this challenging time.

Streamlining ANSI X12 835 Payments and EOBs

Availity assists in processing ANSI X12 835 files containing EOBs, ensuring a smooth electronic workflow for insurance payment posting. Our partnership also facilitates:

Simplified Auto-posting: With 1st Providers Choice’s billing software, clinics automatically receive ANSI X12 835 files from Availity. This capability is efficient for auto-posting of insurance payments and contractual write-offs.

Accurate Patient Balances: For commercial insurance patients, our software processes actual ANSI X12 835 files, facilitating direct posting of insurance payments and streamlining the entire billing workflow. Determine patient balances accurately and generate patient statements without delay. 

Time-saving Solution: Our integrated approach saves providers and billers nationwide significant time on billing, insurance payment posting, and claims management, ensuring efficient operations for breach-affected clinics.

Efficient EDI 837 Processing Solutions

Our software efficiently handles the submission of healthcare claim billing information and encounter details via the EDI 837 format, ensuring compliance and accuracy throughout the healthcare billing process. We also offer:

Seamless Connectivity with Insurers: Healthcare providers can effortlessly connect with insurers, enabling smooth communication and backend operations management. Our software simplifies the complexities of EDI transactions, enhancing overall efficiency.

Enhanced Billing Accuracy: Healthcare providers can significantly improve billing accuracy by utilizing our cutting-edge software. The structured format of the EDI 837 transaction set reduces errors and enhances data integrity, minimizing billing discrepancies.

Prompt Reimbursements: We prioritize prompt reimbursements for healthcare providers. With our software, providers can streamline claims submission, leading to faster processing times and timely reimbursements.

Assisting Practices Through Breach Recovery Efforts

At 1st Providers Choice, we support medical practices affected by the Change Healthcare data breach, helping them recover and settle any billing or reimbursement issues. 

If you are a provider who previously used Change Healthcare as a clearinghouse, you can now use the Availity Essentials platform integrated with our billing software as an alternative. This mechanism helps ensure claims standardization and accuracy, enabling you to transact health plans electronically. 

Covered transactions include eligibility and benefits (X12 270), claim status (X12 276), claims (X12 837 Professional, Institutional, Dental), and remittance advice (X12 835).

Minimizing Disruptions and Restoring Confidence Quickly

1st Providers Choice recognizes its responsibility to minimize disruptions and restore trust among patients and healthcare providers after the recent data breach. 

Our billing software is designed to be HIPAA-compliant, which means it meets the necessary compliance requirements to assure that your protected health information (PHI) is always secure and not at risk of a breach. We follow industry-standard security protocols and regularly update and patch our medical billing solution to counter new threats.

We have included privacy and security policies in our software’s Health Information Exchange (HIE) feature to ensure that PHI is exchanged safely between clinics, laboratories, pharmacies, and other entities related to patient care. These policies promote cybersecurity practices, such as user authentication and access audits, to protect the confidentiality and integrity of your PHI.

Tap Into Our Expertise 

1st Providers Choice and Availity have been working together for a long time to provide electronic billing and claim solutions to practices. In light of the recent breach in Change Healthcare, this partnership will continue to offer strong support to providers who are experiencing disruptions in their healthcare services. 

Our integrated billing software ensures compliance and accuracy in processing healthcare claims, including ANSI X12 835 and EDI 837 transactions. With over 40 years of experience, we are confident in our ability to provide efficient solutions for medical practices of all sizes. 

Call 480-782-1116 or schedule a demo today to safeguard the continuity of your health services!