Change Healthcare's services remain down due to a security incident which began on 02/21/2024.
The exact nature of the security incident is unknown, but current reporting and communications indicate a suspected attack from a foreign nation. It is unclear if PHI has been affected within Change Healthcare. Below are some additional resources regarding the incident:
Etactics utilizes Change Healthcare for some payer routing, including when Change Healthcare acts as the payer's "gateway" or back-end processor, meaning that all transactions must be routed there. Due to this relationship, transactions such as claims, acknowledgment reports, ERAs, eligibility, and claim status are affected for some payers.
The reliance on Change Healthcare is not limited to Etactics. Due to Change Healthcare's relationship with many payers, other large clearinghouses also rely on Change Healthcare and are experiencing similar outages including Availity and Office Ally.
Change Healthcare has not provided a timeline for restoring services. When services are restored, Etactics management will assess the safety and timeline for re-establishing our connections.
Etactics initiates all communications with Change Healthcare systems. The Etactics internal network is fully isolated from Change Healthcare; there is no mechanism by which a threat actor can laterally move to an Etactics system via compromised Change Healthcare hosts. Etactics is performing analysis on all transactions retrieved from Change Healthcare servers. All credentials to Change Healthcare systems will be rotated before re-enabling outbound communications.
Etactics severed all connections to Change Healthcare and related companies, including Optum and Relay Health, upon knowledge of the security incident on 02/21/2024.
Investigations are ongoing with regards to rerouting specific payers and transactions.
Eligibility: The following eligibility payers have been switched from Change Healthcare to alternatives and are functioning appropriately.
The following eligibility payers do not have the ability to route outside of Change Healthcare or would require re-enrollment by customers and remain down:
Claims: Etactics has sent test claims via an alternative connection for the following high volume payers to see if rerouting will work. These payers were selected by volume and confirmation from other partners that they do not connect to Change Healthcare for routing purposes.
We are not confident about the tests to United Healthcare nor UMR, but wanted to test through the alternative vendor just in case they indeed had a separate route to the payers outside of Change Healthcare.
Etactics had already planned to migrate a number of other low volume payers away from Change Healthcare due to cost and service considerations. These payers were migrated today ahead of our schedule and will result in small volumes of claims to take alternate routes. These changes represented 75 payers and will remain at alternate routes even after the Change Healthcare issue is resolved.
Etactics will take the additional actions below if no timeline for restoration is provided by Change Healthcare and services remain down by the start of business on Monday, 02/26.
If Change Healthcare's services remain down, the successful, alternative claim routes will be utilized to send all backlogged claims.
We will then investigate rerouting claims for the next largest payers and send test claims for them. The next largest payers include:
After this, Etactics will continue to investigate and reroute claims for lower volume payers where possible.
Etactics will evaluate new routes for additional low volume eligibility payers.
Claim status routes have been evaluated and will begin to change over to new routes.
When connections with Change Healthcare resumes operations and connections are restored, pending claims and ERAs are expected to function normally. In the event that Change Healthcare requires Etactics to resubmit any claim submissions, Etactics has this capability and will do so on behalf of the customer.
Claims: Submit claims as usual. Claims which would be routed to a payer via Change Healthcare will remain in a “Clearinghouse Accepted” status. When connectivity with Change Healthcare is restored, claims will be sent as usual. If alternative routing for a payer is found, these claims may update their status sooner.
Etactics commits to confirming that claims are received by the next “hop” in the route to the payer. Etactics monitors and investigates claims that are not reported as received by the next entity in the route to the payer.
Real Time Eligibility and Claim Status: Expect some eligibility payers and claim status payers to return an error. As Etactics investigates alternative routes, some payers may become available.
ERAs: ERAs that route through Change Healthcare will be delayed until Change Healthcare restores connectivity. Please be aware of the delay and be sensitive to this issue when submitting missing ERA inquiries.
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