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From Crisis to Continuity: How SYNERGEN Responded to the Change Healthcare Attack

By June 20, 2024No Comments

The healthcare industry was rocked in February when a ransomware attack targeted Change Healthcare, a crucial player in the revenue cycle management (RCM) sector.

This cyberattack profoundly impacted the ability to submit claims and receive payments by SYNERGEN Health’s clients, especially those relying exclusively on systems linked to Change Healthcare.

In response, SYNERGEN Health (SYNERGEN) swiftly initiated a series of proactive measures to mitigate the impact and ensure continuity for our clients.

Change Healthcare cyberattack victim
Phase 1

Immediate Response to the Cyberattack

Upon learning of the cyberattack, SYNERGEN responded swiftly and strategically.

We primarily focused on finding alternative methods for electronically submitting claims to ensure the revenue cycle for their clients remained uninterrupted. After meticulously researching and evaluating various clearinghouses, we determined the optimal choice.

We prioritized transparent communication with affected clients. Our team informed clients about the unfolding events and the proactive measures implemented through regular updates.

To facilitate claim submission, we extracted 5010 EDI-formatted claims from billing systems, customized the format to meet vendor specifications, and submitted the claims electronically in batches.

Additionally, we leveraged the collaboration between billing systems impacted by the outage and the vendor to provide another avenue for electronic claim submission. This partnership helped release pending claims and avoid potential bottlenecks, ensuring a smoother transition for the affected clients.

For claims requiring an EDI agreement for submission, we proactively collaborated closely with client representatives to establish an EDI connection. This was particularly valuable for processing claims to federal payers.

In cases where delays occurred in setting up the EDI connection, we swiftly arranged EDI enrollment directly with the optimal vendor for federal claims submission. As a backup option, we utilized pre-existing arrangements with a third-party mailing vendor to submit paper claims via red CMS-1500s.

Reporting and Communications with Affected Clients

Recognizing the importance of tracking various submission methods for claims, our technology team collaborated with key billing systems to create a designated field for recording the submission method used for each claim. This initiative facilitated the follow-up procedures and enhanced future reporting and analytical capabilities.

  • SYNERGEN maintained clear and consistent communication with affected clients.
    Daily email updates and stand-up calls ensured clients were informed about the progress, fostering trust and assurance during these uncertain times.
  • Additionally, we assisted providers in enrolling for advance payment options offered by Optum and the Centers for Medicare and Medicaid Services (CMS) in response to the Change Healthcare outage.
Phase 2

Efficient Posting and Follow-Up Strategies Amid the Outage

The absence of Electronic Remittance Advices (ERAs) from Change Healthcare due to the outage posed a significant challenge, threatening the cash flow and operational efficiency of affected clients.

Given SYNERGEN’s standard practice of enrolling as many payers as possible to receive ERAs, the impact was substantial, resulting in delayed payment postings and unreconciled transactions. Furthermore, delayed denial notifications meant claims could go unaddressed for extended periods.

To counter these challenges, we deployed a combination of automation, AI-powered technology solutions and the knowledge of our RCM staff to retrieve claim status and rejections directly from payer portals. We searched for alternative methods to directly retrieve 835 files from the payer portals for payment posting. This ensured the most efficient and timely posting of payments and denials, mitigating the impact of the outage on clients' cash flow.

Additionally, we devised a plan to follow up on unresponded claims earlier than usual based on payer response times and timely filing limits. This proactive strategy, executed by our AR follow-up teams, safeguarded against missed deadlines and maximized revenue potential by addressing denials promptly.

Always Prepared for Crisis

In the face of the Change Healthcare outage, SYNERGEN demonstrated exceptional resilience and agility in managing the crisis.

Through collaborative efforts and decisive action, we effectively mitigated the challenges posed by the outage. The quick identification and implementation of alternative claim submission methods, deployment of automation and AI-powered technology solutions or efficient claim status retrieval combined with the expertise of our RCM staff and proactive follow-up strategies ensured that clients experienced minimal disruption.

SYNERGEN’s response to the cyberattack addressed immediate operational challenges and reinforced its reputation as a reliable partner in navigating unforeseen disruptions in the healthcare landscape.

By emerging stronger from this incident, SYNERGEN reaffirmed its commitment to providing robust and resilient solutions in the face of adversity.

To learn more about how we support smooth RCM operations – from day-to-day operations to unprecedented adversity – schedule an opportunity assessment with us today.