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Understanding the impact of the Change Healthcare breach

Understanding the impact of the Change Healthcare breach

Change Healthcare, a subsidiary of UnitedHealth Group that processes claims on behalf of a large number of insurance payers, experienced a cyberattack on February 21st, 2024. After being made aware of the breach, Change Healthcare disconnected their systems to prevent further attack and to protect their partners and clients. This has resulted in disruptions to claim filing that may continue until Change Healthcare has fully resolved the issue. 

Important: SimplePractice data security wasn't impacted by this breach and your information remains secure.

See our FAQs below for how this may impact your practice: 

Important: This is an ongoing incident that we’re closely monitoring. This guide will be updated as we continue to receive information. 

Where can I get updates?

Note: We’re updating this guide with information as we receive it. This section will highlight the most recent updates we’ve received. 

Availity, a trading partner our clearinghouse processes certain claims through, announced that they’ve reconnected to Change Healthcare via a rebuilt clearinghouse called CHC Green System, that will replace the impacted one starting April 8th. While connections have started to be reestablished, it may take time for all transaction types to come back online. This means delays can still be expected. During this time, claims may be returned as rejected. For more information, including what steps to take, see Why are my claims being rejected?

Eligible, our primary clearinghouse, shared that they’ve begun restoring connections with impacted payers as of March 25th. Payers with whom a connection has been reestablished will see claims being accepted for processing midway through the week of March 25th. Please note that this doesn’t mean a full resolution has been reached, and certain payers will continue to see processing delays until all connections have been reestablished. For a list of payers that Eligible has indicated you can now file claims to, see Can I file claims in the meantime?

How does this breach affect me?

Our clearinghouse processes claims to certain payers through Change Healthcare. Because Change Healthcare has disconnected their systems as a result of the breach, processing delays can be expected for claims and ERAs, with resolutions occurring at different times depending on the payer. 

Is my practice and client information secure?

SimplePractice data security wasn't impacted by this breach. Your information remains securely hosted with our Tier 1 cloud-based provider, that meets HIPAA and HITRUST security requirements. Additionally, our comprehensive HITRUST certification, which covers the entire SimplePractice web platform, affirms our commitment to the highest security standards, including HIPAA, PCI, NIST CSF, ISO 27001, and ISO 27002. 

Can I file claims in the meantime?

Delays should be expected for any claims recently submitted to an impacted payer. If you submit claims to a payer that's still impacted, we recommend reaching out to them directly, as they may have an online portal for direct claim submission you can leverage in the meantime.

Our primary clearinghouse, Eligible, has indicated that they’ve reestablished connections for the following payers: 

  • UPMC Health Plan
  • Horizon Blue Cross Blue Shield 
  • Aetna Better Health of Kansas
  • Intercommunity Health Net
  • Providence Health Plan
  • Meritain Health Minneapolis
  • Optima Health Plan
  • Automated Benefit Services (ABS)
  • Curative
  • Western Pennsylvania Electrical Employees Insurance Trust Fund
  • Western Health Advantage
  • Hoag
  • Sanford Health Plan Medicare Advantage
  • Unified Life Insurance Company
  • University Health Alliance
  • Geisinger Health Plan
  • Gravie Inc.
  • CareOregon Inc.
  • Comprehensive Benefits Administrators Inc
  • Select Health of South Carolina
  • Providence Behavioral Health
  • AlohaCare

Claim connections for these payers have been reestablished and you can resume filing claims electronically. However, ERA delivery is a separate transaction type and some of these payers may use different trading partners for their delivery. This means that if you successfully submit claims to these payers, ERA delays can still be expected. 

Claim connections have not yet been established for the following payers: 

  • Nomi Health
  • Washington County General Fund
  • Univera Health Care Plan Choicecare (Buffalo)

Claims submitted to the above payers may be stuck in the Submitted status as our clearinghouse attempts to reestablish a connection.

Are payments coming through for claims submitted before the outage?

Payments should still be received so long as the claims are successfully processed. However, since there are disruptions to claim processing payments may be delayed. 

How are Payment Reports impacted?

Payment Report delivery is also delayed as a result of the breach. Our clearinghouse has confirmed that Payment Reports will eventually be delivered to SimplePractice accounts, but we’re unable to offer a timeline for when that may be. 

Our clearinghouse has clarified that while alternate claim filing routes can be found for some of the impacted payers, Payment Reports can’t be routed through a separate trading partner. This means you may see claims that were previously delayed become accepted for processing, but won’t receive a Payment Report until all services are restored. 

We’ve confirmed with our clearinghouse that the following payers were impacted by this breach and you can expect delays in receiving Payment Reports:

  • Kaiser Foundation Health Plan of Southern California
  • Kaiser Foundation Health Plan of Southern CA Region
  • Kaiser Foundation Health Plan of Northern California
  • Kaiser Foundation Health Plan of Northern CA Region
  • Blue Cross Blue Shield of New Jersey
  • CareFirst BCBS - National Capital Area
  • Providence of Oregon Health Plan
  • Care Oregon
  • UPMC Health Plan - Commercial
  • Meritain Health Minneapolis
  • CBSA (Corporation Benefit Services of America)
  • Aetna Better Health - Kansas
  • 1199 National Benefit Fund
  • Intercommunity Health Net
  • Priority Health
  • Blue Cross Blue Shield of Maryland
  • Aetna
  • Prime West Health Plan
  • PacificSource Health Plans
  • Aetna Better Health of West Virginia
  • Capital District Physicians Health Plan
  • Blue Cross Blue Shield of Vermont
  • South Country Health Alliance
  • Driscoll Children's Health Plan
  • ChampVA-HAC
  • Community Care BHO
  • Health New England
  • Martin's Point Health Care
  • Capital District PHP
  • Key Benefit Administrators
  • Health Alliance Medical Plans
  • Healthfirst of NY
  • Group Health Cooperative of South Central Wisconsin Claims
  • Dean Health Plan
  • HealthTeam Advantage
  • Texas Children's Health Plan
  • Student Resources
  • Medicaid of South Dakota
  • Hennepin Health
  • Medicaid of Louisiana 
  • Carolina Care Plan
  • Health Alliance Plan of Michigan 
  • Avera Health Plans
  • Kaiser Permanente Hawaii

We’ll update this list as we learn more. If you experience missing Payment Reports from a payer not listed here but that may have been impacted by this breach, please submit an email help request and our team will be happy to assist.

Why are my claims being rejected?

Availity, which is a trading partner our clearinghouse processes certain claims through, recently terminated all connections with Change Healthcare as a result of the breach and has begun establishing connections with a new clearinghouse. This means claim submissions that were previously paused while Availity attempted to establish a new connection are now being returned as rejected. 

As Availity has begun reestablishing payer connections, recently submitted claims may be able to process. If you’ve recently been able to submit a claim to a payer that returned earlier claims as rejected, it’s likely a new connection has been established and you can begin deleting and resubmitting rejected claims. Before deleting any claims, we highly recommend downloading a copy and saving the clearinghouse reference number and payer claim number for your records. 

Alternatively, you may contact the payer to explore alternative claim submission pathways, including Direct Data Entry (DDE) or downloading the claims for paper submission. Until United/Change Healthcare announces a full resolution, we encourage you to file claims to impacted payers outside of SimplePractice.

Please note that while we currently recommend alternative claim submission pathways, we’re working with our clearinghouse to restore connections to all impacted payers.

When will this be resolved?

While we’re continuing to work with our clearinghouse to find available routings for claims and Payments Reports, we’re currently unable to provide a definitive resolution timeline. As the disruption has occurred with an external third-party, the ultimate resolution is not within SimplePractice’s control.

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