Change Healthcare Incident Update 04/02/2024

Change Healthcare Incident Update 04/02/2024

Reconnection to Change Healthcare's Relay Exchange Clearinghouse


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#}”

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. 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. 

Etactics Payer Routing Website Updates

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.



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