After a cyberattack on Change Healthcare forced its systems offline last month, clinicians and insurers aren’t the only ones affected. The healthcare tech group’s rivals have had to pivot at short notice to handle a massive jump in customers.
Availity, one of those competitors, is in the process of hiring around 20 new staff to manage the sudden influx.
New consultants are helping onboard healthcare providers who have been unable to submit claims through Change’s electronic payments platform for more than two weeks, said Russ Thomas, chief executive officer of Availity. “It’s been exhausting for a lot of us,” he said.
Change, which is owned by insurance giant UnitedHealth Group through its Optum unit, was forced to disconnect more than 100 systems after the ransomware attack on Feb. 21. The outage has created a crisis for hospitals, healthcare providers and pharmacies that suddenly lost access to the largest clearinghouse for insurance billing and payments in the U.S. Many have been unable to take in any revenue since the outage struck.
“If we have an occasional item that lasts for even five or 10 minutes, it’s disruptive. And so anything that lasts for a day or longer is going to have a material impact on the system,” Thomas said.
Healthcare providers are sitting on hundreds of thousands of dollars worth of claims that they haven’t been able to submit, he said. A customer that Availity is currently onboarding has around $1 billion of held claims, according to Thomas. In total, Availity has processed more than $5 billion in claims that couldn’t be submitted through Change’s systems.
After the hack, Availity set up a pared-down claims-processing service on Feb. 23 that medical providers can use for six months at no cost. The company has set up around 300,000 medical providers so far and has a backlog of at least 50 health systems waiting to start using the platform, Thomas said.
Availity’s CEO said he didn’t want to charge desperate healthcare companies in the middle of a crisis, and negotiating contracts would have meant a lot of work for the company’s employees. After the six-month contract-for-free service ends, Thomas said customers can decide if they want to keep using Availity’s platform or want to return to Change. “This event is going to sort of forever change the dynamics in this space,” he said.
UnitedHealth has set up workarounds while it works toward restoring Change’s electronic payment and medical claims systems, which it expects to start on Friday. The company said its Optum Intelligent Electronic Data Interchange product, which can facilitate some transactions in the interim period, has signed up more than 100 payers, and is connected to healthcare providers responsible for more than 30 million claims a month.
Hospital systems and other healthcare providers that depended on Change to file claims were left scrambling after the hack, with many worried about cash flow, said Errol Weiss, chief security officer of the Health Information Sharing and Analysis Center, a nonprofit that facilitates the exchange of information about cyber threats between healthcare organizations.
“Switching service providers, especially under those enormous pressures, is a complex task,” he said.
Some healthcare providers said they couldn’t use alternative clearinghouses to submit patient claims because it would take too long to implement their systems. Dr. Jordan Stern, director of the New York-based sleep apnea clinic BlueSleep, said he had been told during the early days of the Change outage that it would take a month to change over to Availity and other providers.
Others said they were using the company’s platform but doing so required manually inputting patients’ details, which took far more time than doing so on Change’s software.
The Center for Child Development, a mental-health practice in Newark, Del., that primarily serves children and adolescents, started using Availity to submit claims since the cyberattack on Change. The process was too time-consuming for staff and the organization eventually stopped using Availity and switched to another provider, said Lisa Savage, founder and chief executive of the organization.
Thomas said providers who struggled to submit claims or start implementing the system were likely attempting to use Availity’s full product, which is different from the new service and requires customizations for each customer’s needs and policies. It would take months to set up so many new customers on that system, he said.
It takes between 48 and 72 hours to set up providers on the stripped-down, free service, Thomas said. Around 99% of claims submitted through the platform have been adjudicated by insurers, he said.