On Wednesday, February 21, NueMD/AdvancedMD was made aware that Change Healthcare (a subsidiary of Optum), experienced a cybersecurity event (cyberattack). As of the posting of this FAQ, Change Healthcare has confirmed its Medical Network and Medical Network API systems are unavailable.
As we continue to work through the Change Healthcare outage, we would like to offer an update and additional guidance.
On Wednesday, March 27, we began submitting backlogged claims through the Change Healthcare Relay Exchange clearinghouse. That effort has continued and we are ready to restore this service for new claims starting Friday, March 29. See below for more details on this and other important updates.
What can I expect now that Change Healthcare services are being restored? NEW 4/2
We have now begun submitting claims to Change Healthcare. We continue to work with Change as other services begin to come online too.
We have continued our efforts throughout the weekend to submit the backlog of claims built up between Feb. 22 and March 28 to Change Healthcare. The backlog was cleared as of March 31. As a result, you should start seeing responses in the coming days associated with these claims.
For any claims you submitted between 2/21 and 3/28 our EDI service has captured these and we are processing these as part of our backlog. Please do not try to resubmit these claims at this time. We will notify you when this backlog has been cleared. After that time, you can resume with refiling any rejected claim in line with the steps set out below.
It is important for you to know that as we proceed with the submission of claims there will be a subset that are rejected at the clearinghouse because payors are not yet reconnected.
The list of connections is available through Change Healthcare. This Payor List is updated daily as more and more payors reconnect.
Current or “live” claim submission began over the weekend and will continue as normal from this point forward. This means that NEW claims you ticket and build out will transmit real-time though to Change Healthcare as normal. Again, please do not resubmit claims built out between 2/21 and 3/28 at this time.
For NEW or CURRENT claims please continue to be aware that not all payors are reconnected, and we do anticipate some rejections based on this. The list of connections is available through Change Healthcare. This Payor List is updated daily as more payors reconnect.
If you do get rejections, you can again follow these steps:
Specific details about every one of Change Healthcare’s service restoration can also be found on the Change Healthcare status page
How should we handle claims during the outage?
You should continue to run claims submissions as normal. Your claim files will be held by NueMD/AdvancedMD in a queue until Change Healthcare services are restored.
NueMD submits claims directly to many carriers, so we have shown only a 30% reduction in our successful claim submissions. If you are experiencing an impact in claim volume over this threshold or have claims that are meeting their timely filing deadlines, please contact the support team at (800) 401-0785 to discuss alternative actions that may be taken.
WARNING: Do not mass rebill any claim runs since the outage started on February 21. Once the outage is resolved, acknowledgement reports for claim runs will be delivered as normal as the queue and backlog are cleared.
Are carriers accepting paper submissions?
Please reach out to your carriers for more information on if and how they accept paper claims.
Are ERAs being returned? NEW 4/2
Some backlogged ERAs, for claims submitted just before the 2/21 incident, have been returned BUT for any claims submitted or cleared after 2/21/24 we have not yet begun to receive ERAs for the claims. As these services are restored we will update you accordingly.
What about Eligibility? NEW 4/2
Change Healthcare have indicated that they are getting closer to reestablishing Eligibility services in the next week. With that we anticipate a similar process to the one we saw with the Claims services, including validation of 3rd Party assurance attestations. We anticipate they will round out some internal testing, ask us to do the same on our end, before reconnecting and recredentialling. We then expect the restoration and activation of service for clients. As this evolves, we will share more detailed information and dates.
Has Change Healthcare provided the priority it will use to restore services? In what order will services be restored?
Change Healthcare senior leaders have indicated that dedicated teams are working on all systems in parallel. This means that individual services can be restored at any time as soon as they are tested and deemed safe. However, Change Healthcare is placing the highest priority on services like ePrescribing that have direct impact on patient safety. Next in order are services that have a significant impact on revenue, like claims and preauthorization.
This continues to be the plan and the message. Change Healthcare announced the following on March 18:
“By the end of the week, we expect our largest clearinghouse, Relay Exchange, will be back online. Reconnection will begin with channel partners and other clearinghouses, to enable claim submission to payors. Phased reconnection and testing will continue into the week of March 25 as operations ramp up.”
Will Change Healthcare and NueMD/AdvancedMD be able to handle the large volume of claims being processed when services are restored? NEW 3/27
NueMD/AdvancedMD is designed to handle interruptions in service at Change Healthcare. Change Healthcare routinely has weekend maintenance. When these planned outages occur, we turn off services and then turn them back on when we receive notification that the maintenance window is open. While this outage is much longer than a typical weekend outage, we are using the same process of queueing claims until Change Healthcare services resume.
As of 3/27/24 we have begun are now resume our claims submissions through Change Healthcare. We have worked through the backlogged claims . These are the claims that were not rerouted to other clearinghouses and accumulated since Feb 21. As of 3/29/24 we began submitting real time, ‘current’ claims.
What will happen with Eligibility and Claims Status Inquiries once services are restored?
Eligibility requests will continue to generate for new appointments based on your system default setting.
On Wednesday, February 21, NueMD/AdvancedMD was made aware that Change Healthcare (a subsidiary of Optum), experienced a cybersecurity event (cyberattack). As of the posting of this FAQ, Change Healthcare has confirmed its Medical Network and Medical Network API systems are unavailable.
When did the security incident happen?
Change Healthcare identified the attack very early on Wednesday, February 21, and shut down systems at about 5am EST.
What type of cyberattack took place?
Change Healthcare has reported to partners and the media that they experienced a sophisticated cyberattack that is consistent with state-sponsored cyberterrorism. The ransomware that caused the incident has been reported by news media as ALPHV BlackCat.
What Change Healthcare systems were impacted by the cyberattack?
Change Healthcare indicated the attack directly impacted its “internal systems.” We’re told the production systems were not directly impacted, but connections were shut down out of an abundance of caution because they are “adjacent” to the impacted systems, meaning that there is a possibility of lateral movement of the attack.
Where is the best place to stay informed?
The NueMD/AdvancedMD Incident Management team will continue to monitor the outage and resolution timing. We will continuously update this FAQ page, and provide software alerts to keep you informed with the latest information.
Change Healthcare also has a cyber response page with details that may be helpful and insightful
What is the relationship between Change Healthcare, UnitedHealth, and Optum?
UnitedHealth Group and its subsidiary, Optum, acquired Change Healthcare when it was a separate company in a deal that was closed in 2022. Change Healthcare is now part of Optum, the health services division of Minnesota-based UnitedHealth.
Change Healthcare is owned by Optum, which is a subsidiary of UnitedHealth Group. Were any Optum or UnitedHealth systems impacted?
From the Change Healthcare status page: “We have a high-level of confidence that Optum, UnitedHealthcare and UnitedHealth Group systems have not been affected by this issue.” Source: Optum Solutions Status – Update: Some applications are experiencing connectivity issues.
Was any patient data (PHI) exposed in the attack?
Change Healthcare indicated that it is too early in the investigation to say whether any PHI was exposed in this attack. Change Healthcare has assured us that it will provide an assessment as soon as possible.
What is Change Healthcare doing to remediate this incident?
UnitedHealth Group has assembled “three of the best security forensics companies in the world” to help its internal experts diagnose the issue, determine scope of the impact, remediate the incident, and provide an impact report to customers, including AdvancedMD. UnitedHealth has assured us that it has all available resources working 24 hours a day (in two 12-hour shifts) until remediation is complete.
Is there any risk to NueMD/AdvancedMD servers and databases?
There is no reason to believe that NueMD systems could have been impacted by this incident. There is no VPN or other continuous connection between NueMD and Change Healthcare, and any data that is exchanged between the two platforms is pushed or pulled by AdvancedMD. Change Healthcare has no mechanism to push data into the NueMD infrastructure. Also, Change Healthcare shut down all services as soon as the attack was identified, which minimized the interaction between NueMD and Change Healthcare after the incident took place.
NueMD has many security controls in place to prevent and detect security incidents. Our security team has found no indication of any impact in our systems from the cyberattack on Change Healthcare.
What services are impacted (such as claim submissions, EDIs, ERAs)?
See the Change Healthcare status page. The main areas of interest for NueMD and our customers are Clinical Networks, Medical Network, and Medical Network APIs.
Practice Management Services –
ePrescribing Services –
eLaboratory Services –
Does the Change Healthcare outage impact patient statements?
If you have selected option #2 or #3 in the Account Settings>>Statement tab of NueMD for statement outsourcing, your statements have been affected. Please call NueMD support at (800) 401-0785 to get assistance with switching to option #1 or you may elect to wait until Change Healthcare resumes service. You may also elect print statements in your office and mail them as needed.
Are some payors not able to make payments due to the Change Healthcare outage (outside of the ability to send ERAs and receive claims)?
Yes, there are payors that use Change Healthcare payment services to facilitate payments which have been affected by the outage. Change Healthcare is working directly with these payors with alternate payment solutions. Please contact your payors directly if you are concerned about those not making payments you expect to receive. This service is between Change Healthcare and the impacted payors directly and is not related to the AdvancedMD integration or relationship with Change Healthcare.
How long has NueMD held claims?
All NueMD claims were held starting when Change Healthcare shut down its claim submission service Wednesday morning, February 21. As soon as the outage is resolved, all your claims held in queue should process automatically.
Have any claims been submitted to Change Healthcare since the start of the incident?
The Change Healthcare claim submission services have been shut down. It is not possible to submit claims since then.
Was there any impact to PHI? If so, how do I know if my practice or patients were impacted?
This question comes up on every security call. Change Healthcare is not prepared to answer this question yet, but the company has assured us that we will be notified as soon as there is enough forensic evidence to provide a clear and accurate answer.
What is the expected resolution date? NEW 3/27
As of the week of March 25 we have begun to submit claims, beginning with the backlog that has built up since Feb 21.
Change Healthcare has restored the Relay Exchange clearinghouse the week of March 25. Testing between NueMD, and the restored Relay Exchange, has been done and we have begun submitting claims. Insurance eligibility is scheduled to be restored during the week of March 25. Payor Connectivity Services (PCS) is scheduled to be restored the week of April 1, which means we may see a higher rejection rate of claims through Change Healthcare until PCS is restored.
Relay Exchange is the name of the clearinghouse that we use from Change Healthcare. This is a positive update, but we do not have an exact date when Change Healthcare services will fully be restored. We also do not yet know the impact or timing of payors that have disconnected from Change. Change Healthcare and we are dedicated to resuming services fully as quickly as possible.
Change Healthcare will provide a third-party security assertion for each of it’s services that we will review before restoring services. Having now resumed claims processing through Change Healthcare, we will continue to support our other additional claims processing methods and continue to work with Change Healthcare to stand up and resume other services progressively along the tie frames noted.
Is my data secure?
At this time there are no indications that the data of NueMD customers in the possession of Change Healthcare has been compromised. However, the forensic analysis is still underway. As more information becomes available, we will continue to share updates.
The security of NueMD/AdvancedMD servers and databases was not impacted by this incident.
Jed Shay, MD
The Pain Care Center
Keith Berkowitz, MD
Center for Balanced Health
Estaban Lavato, MD
La Loma Medical Center
Raju Raval, MD
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