Client Overview:
In February 2024, a cyber attack on Change Healthcare significantly impacted the billing operations of a multi-specialty practice. The in-house billing team faced numerous challenges, including difficulties in submitting claims electronically and delays caused by a manual payment posting process. These issues led to a substantial decline in revenue and overwhelmed the staff.
Challenge
The multi-specialty practice experienced severe disruptions due to the cyber attack:
- Inability to efficiently submit claims electronically
- Manual payment posting process causing considerable delays
- Overwhelmed staff struggling to complete essential tasks
- Declining revenue due to operational inefficiencies
Solution
To address the crisis, we implemented a strategic and systematic approach:
Comprehensive Portal Strategy:
We compiled a detailed list of approved portals for claim submissions by each insurance provider. This enabled immediate claim processing without reliance on the compromised clearinghouse.
Optimized Submission Processes:
Our analysis revealed that most insurers used Availity Essentials, while Medicare and Medicaid required submissions via NGS Connex and ePaces, respectively. This insight allowed us to streamline the submission process for each claim type.
Expert Team for Manual Submissions:
With a monthly volume exceeding 6,000 claims, our skilled team of expert billers efficiently managed manual submissions, ensuring that claims were processed without unnecessary delays.
Payment Tracking and Posting:
We diligently tracked payment remittances to ensure timely and accurate payment postings. This step was critical in maintaining financial stability despite the clearinghouse disruption.
Results
Our efforts restored a steady cash flow within just two months, even with the dysfunctional clearinghouse. Payment posting was up-to-date, and the client experienced significant operational relief.
Before K Med Billing:
Feb 2024 Collections = $237,665.91
Mar 2024 Collections = $18,076.40
After K Med Billing:
April 2024 Collections = $225,037.57
May 2024 Collections = $795,684.70