The cyberattack on Change Healthcare in February has resulted in a surge of denied claims for hospitals and health systems, creating significant financial and operational challenges. Many providers were unable to submit claims electronically, leading to both clinical and technical denials.
To address this issue, providers should prioritize communication with payers, explaining the steps taken during the technology outage and demonstrating their efforts to overcome the challenges. It’s crucial to engage with department leaders to understand the impact of the cyberattack and inform payers of the hospital’s efforts.
Hospitals should coordinate their teams to manage different types of denials, review and adjust workflows, and maintain detailed documentation of their workaround efforts during the service stoppage. This documentation will be vital when creating appeals and demonstrating compliance with payers’ administrative requirements.
Providers should stay informed about interim policies and procedures implemented by payers in response to the cyberattack. They should also provide education and training for all staff involved in the denials management process, ensuring everyone is aware of timelines and specific steps to be taken.
Lastly, hospitals are advised to appeal and advocate for their position vigorously. They should work closely with their managed care departments and provider representatives, seeking expert advice if needed. The message is clear: don’t give up on these denials, as there are resources available to help providers navigate this challenging situation.
Read full Becker’s Hospital Review article.