Reconnection to Change Healthcare's Legacy Change Healthcare Clearinghouse for Eligibility
The Etactics management team worked with Change Healthcare last week and over the weekend to discuss reconnection. Etactics has received sufficient evidence from Change Healthcare that provides confidence to reconnect to the “Legacy Change Healthcare” (AKA Legacy Emdeon or OKC) platform for eligibility services only. Legacy Change Healthcare is one of three clearinghouses owned by Change Healthcare that Etactics connects to and that were affected by the outage. This evidence includes documentation from both Change Healthcare and external security vendors who have conducted scans and penetration testing.
Etactics has reconnected with Change Healthcare’s Legacy eligibility Platform, which Change Healthcare is now referring to as the Intelligent Medical Network (IMN) platform.
Payers who had not been able to be rerouted for eligibility were tested through the IMN platform and reactivated if they passed testing.
Restored eligibility payers are included on our Change Healthcare payer list:
Change Healthcare is continuing to bring on more eligibility payers to its IMN platform. Etactics will check this list and update our connections daily, along with our payer list. There is no estimated timeframe for eligibility connections to be restored for the Change Healthcare Relay Exchange platform.
Payer Rejected Claims Due to Outage
In an effort to accelerate our claims rerouting, Etactics became more aggressive and abandoned our lengthy testing process. Instead, we rerouted roughly half of our held claims on 04/09/2024. When a claim is rejected by the next vendor due to the Change Healthcare incident, Etactics will update the claim’s status back to “Clearinghouse Accepted” and continue searching for a new route. We will also update our website.
The specific rejection messages due to vendors having Change Healthcare as their route are as follows:
Plan for Electronic Remittance Advices (ERAs)
Etactics understands the burden that its customers are under to manually post ERAs by utilizing EOBs for payers affected by the Change Healthcare outage. Etactics and Change Healthcare are exploring the option of potentially moving all enrollments from Legacy Change Healthcare (AKA OKC) to Legacy Relay (AKA Relay Exchange). We are currently working with Change Healthcare to determine if the restoration of Legacy Change Healthcare or moving enrollments to Relay Exchange automatically would be the faster option.
Discussions have accelerated over the previous week.
Etactics Payer Routing Website Updates
Our payer routing list continues to be updated daily: https://etactics.com/change
Relay Exchange is one of three clearinghouses owned by Change Healthcare that Etactics connects to and that were affected by the outage.
Etactics and Change Healthcare worked together on 04/01/2024 to reconnect to the Relay Exchange clearinghouse for both claims and ERAs (remits). This occurred after rotating credentials and receiving evidence regarding Relay Exchange’s security and stability.
Held claims for Relay Exchange were released. However, Etactics found payer rejections for some payers indicating that Relay Exchange had relied on the other Change Healthcare clearinghouse (Legacy Change Healthcare) which is still down. Etactics will re-investigate alternate routes for these payers.
ERAs for payers which had routed through Relay Exchange are now starting to come to Etactics. However, not all payers have reconnected with Relay Exchange meaning that not all ERAs are flowing through Etactics for Relay Exchange at this time.
Each payer will choose whether or not to requeue and send all backlogged ERAs since disconnecting from Relay Exchange.
Etactics will monitor ERAs and update our tracking website on a daily basis. When an ERA for a payer is received from Relay Exchange, the column Is Functional will be set to Yes, the Current Vendor column will be set to Legacy Relay, and the Payer Updated date will be updated as of the first ERA received since the outage.
Please see our payer list at https://etactics.com/change to see which payers were connected through the Relay Exchange (“Legacy Relay”) route versus the other routes (Legacy CHC and Dental).
There is not currently a timeline published by Change Healthcare for restoration of either the Legacy Change Healthcare or the dental platform. There is also not a current timeline for restoration of eligibility or claim status through Relay Exchange.
Payer Rejected Claims Due to Outage
Etactics has been carefully working through the list of payers formerly routed through Change Healthcare to find alternate routes. This process had included testing to make sure that the claims were accepted by the next entity in the process (usually another vendor).
Despite our testing, in some cases these claims have been rejected by the alternate vendor as that vendor had also used Change Healthcare as their route to the payer. Etactics attempted to remedy this situation by asking vendors to tell us which of their payers also routed through Change Healthcare. This has helped, but we have then run into the issue where our alternate vendor had a vendor who also utilized Change Healthcare and they were not aware.
In an effort to accelerate our claims rerouting, Etactics will be more aggressive and forgo the testing process. Instead, we will begin to reroute claims en masse and monitor for rejections with specific language. When a claim is rejected by the next vendor due to the Change Healthcare incident, Etactics will update the claim’s status back to “Clearinghouse Accepted” and continue searching for a new route. We will also update our website.
The specific rejection messages due to vendors having Change Healthcare as their route are as follows:
Availity: “DUE TO THE CHANGE HEALTHCARE CYBERATTACK AVAILITY DOES NOT CURRENTLY HAVE AN ELECTRONIC PATH AVAILABLE FOR THIS PAYER. PLEASE LOOK FOR ALTERNATE ROUTES FOR CLAIM SUBMISSION FOR THIS CLAIM UNTIL FURTHER NOTICE.”
Relay Exchange: “PAYER ID IS EXPIRED {#ID#}”
Etactics understands the burden that its customers are under to manually post ERAs by utilizing EOBs for payers affected by the Change Healthcare outage.
Our team has worked tirelessly to ensure that claims have suitable routes so that all customers and providers are able to be paid. As this project nears completion, the conversation naturally shifts to resolution of ERA routing issues.
Unlike claims, nearly all payers require enrollment for ERAs. This provides a large challenge when discussing a mass conversion from one vendor to others.
We believe that by starting the enrollment process for all NPIs and all affected payers could potentially cause more issues than it solves. Enrollment through other vendors or directly through the payers can span from weeks to months (ex: Aetna). Given the response times and delays that other vendors are experiencing, we anticipate that enrollments would be slower than usual.
In short, we believe that re-enrolling all NPIs with all affected payers would provide additional burden on providers to fill out paperwork and may take longer than the Legacy Change Healthcare restoration.
To that end, Etactics and Change Healthcare have discussed a contingency plan of potentially moving all enrollments from Legacy Change Healthcare (Legacy CHC) to Legacy Relay. We are currently working with Change Healthcare to determine if the restoration of Legacy Change Healthcare or moving enrollments to Relay Exchange automatically would be the faster option.
Updates have been posted to our tracking website: https://etactics.com/change
Column headers have been updated to better describe restoration efforts:
Alternative to CHC Found has been updated to Is Functional
Date Moved to Alternative Vendor has been updated to Payer Updated
The payer's listed for ERAs (also known as remits) may not reflect how a customer originally enrolled for remits with Etactics. The listed payers for remits are where any new customer would route through Change Healthcare, but existing customers may have a different route.
If you are missing remits for a payer that is not on the list, there is a chance that the missing remit is still tied to the Change Healthcare outage.
Similarly, if you are receiving remits for a payer that is on the list, this does not necessarily mean that you are receiving remits that were routed through Change Healthcare.
The Search Bar can be utilized to search by Payer ID, Payer Name, LOB, and Current Vendor.
Each column can be sorted by clicking on the column header.
Please allow time for the search to complete or columns to be sorted.
Reconnection to Change Healthcare's Relay Exchange Clearinghouse
The Etactics management team worked with Change Healthcare last week and over the weekend to discuss reconnection. Etactics has received sufficient evidence from Change Healthcare that provides confidence to reconnect to the “Relay Exchange” (AKA Legacy Relay) platform. Relay Exchange is one of three clearinghouses owned by Change Healthcare that Etactics connects to and that were affected by the outage. This evidence includes documentation from both Change Healthcare and external security vendors who have conducted scans and penetration testing.
Etactics will be reconnecting with Change Healthcare’s Relay Exchange Platform and expects the connection to be re-established this week.
Connections for claims, claim status, and eligibility through the Relay Exchange platform are expected to be restored. Etactics is working with Change Healthcare to determine the status of ERAs (remittances).
Please see our payer list at https://etactics.com/change to see which payers were connected through the Relay Exchange (“Legacy Relay”) route versus the other routes (Legacy CHC and Dental).
There is not currently a timeline published by Change Healthcare for restoration of either the Legacy Change Healthcare or the dental platform.
Plan for Electronic Remittance Advices (ERAs)
Etactics understands the burden that its customers are under to manually post ERAs by utilizing EOBs for payers affected by the Change Healthcare outage.
Our team has worked tirelessly to ensure that claims have suitable routes so that all customers and providers are able to be paid. As this project nears completion, the conversation naturally shifts to resolution of ERA routing issues.
Unlike claims, nearly all payers require enrollment for ERAs. This provides a large challenge when discussing a mass conversion from one vendor to others.
We believe that by starting the enrollment process for all NPIs and all affected payers could potentially cause more issues than it solves. Enrollment through other vendors or directly through the payers can span from weeks to months (ex: Aetna). Given the response times and delays that other vendors are experiencing, we anticipate that enrollments would be slower than usual.
In short, we believe that re-enrolling all NPIs with all affected payers would provide additional burden on providers to fill out paperwork and may take longer than the Legacy Change Healthcare restoration.
To that end, Etactics and Change Healthcare have discussed a contingency plan of potentially moving all enrollments from Legacy Change Healthcare (Legacy CHC) to Legacy Relay. This is contingent on re-establishing our connection with Relay Exchange and receiving ERAs from this connection first. Once this connection has been re-established and ERAs are coming through as expected, we will work with Change Healthcare to determine if the restoration of Legacy Change Healthcare or moving enrollments to Relay Exchange automatically would be the faster option.
Etactics Payer Routing Website Updates
Updates have been posted to our tracking website: https://etactics.com/change
This page now lists the Change Healthcare route being utilized for each payer so that customers can track which payers may be close to resolution.
The payers listed for remits (also known as ERAs) may not reflect how a customer originally enrolled for remits with Etactics. The listed payers for remits are where any new customer would route through Change Healthcare, but existing customers may have a different route.
If you are missing remits for a payer that is not on the list, there is a chance that the missing remit is still tied to the Change Healthcare outage. Similarly, if you are receiving remits for a payer that is on the list, this does not necessarily mean that you are receiving remits that were routed through Change Healthcare.
The Search Bar can be utilized to search by Payer ID, Payer Name, LOB, and Alternative.
Each column can be sorted by clicking on the column header.
Please allow time for the search to complete or columns to be sorted.
Assurance, our medical claims preparation software, is back online. On March 18, testing and implementation began with our first providers. Reconnection with thousands of providers will occur in phases throughout the week. By the end of the week, we expect all Assurance users — including thousands of hospitals across the country — will have complete functionality enabled again, including claims editing. Using the software, providers can begin preparing the backlog of claim files that accumulated during the outage.
We expect to have third-party documentation available prior to services becoming operational. Following this initial phase, remaining services restoration will continue through ongoing phases of activation until all customers have been connected.
By the end of the week, we expect our largest clearinghouse, Relay Exchange, will be back online as well. Reconnection will begin with providers, including Assurance customers, channel partners and other clearinghouses, to enable claim submission to payers. Claims prepared in Assurance will not be released to payers until this happens.
Phased reconnection and testing will continue into the week of March 25 as operations ramp up. Given the amount of volume that has already transitioned to other submission solutions and the phased approach, system capacity challenges are not expected. We are coordinating with other clearinghouses.Notably, there will be a small subset of claims submitters — mainly channel partners — who do not have the capability to connect with Relay Exchange. We will work with those submitters directly to find other solutions.
Outreach for Assurance and Relay Exchange customers started on March 15. Teams will continue to outreach to clients to help with the reconnection process and provide specific instructions and support needed. Until that happens, we encourage providers who have cash flow challenges to participate in our temporary funding initiatives.