Overcoming the Change Healthcare Challenge
The Change Healthcare/Optum Payment Disruption (CHOPD) has caused many challenges for providers, specifically small to medium practices, regarding submitting claims, obtaining patient benefits, getting insurance remits, and receiving and even getting payments for the services rendered. So, what can these providers do to ensure that they are still able to practice and get paid and not have to shut their doors due to the issues caused by CHOPD.
Use a different clearing house. There are many great clearing house entities out there and some of the best ones with low cost and ease of using are——Availity, Claim MD, and Practice Fusion.
Use CMS’s CHOPD accelerated/advanced payments to help offset the loss of revenue due to the Change outage. Click this link to see how to enroll and obtain these payments.
Submit your claims on your new EDI/Clearing house daily and follow up to ensure those claims were not rejected or pushed back for corrections prior to the close of business.
Understand that if you switch to a different claims submission/EDI application, you will need to know what insurances use Change to receive those claims, and either fax paper claims to those insurance companies or submit those claims directly on those insurances portals. This is the fastest way to get your claims paid, avoid timely filing denials, and get the money to your practice.
Use insurance company portals to check on the status of claims and track payments so that you can see when those payments were made and when to expect them into your bank account.
Look at outsourcing your claims as billers are aware of all the ins and outs that come with billing and turning around the billing into revenue in a very quick fashion. These companies are also aware of the Change issues and how to work around them to ensure that your payments are not delayed.
No matter what you decide to do, you need to do what is best for your practice, patients, and revenue cycle for your organization. It is important to research your options and then do not look back. Change has had many issues over the years and while they are the largest system across the United States regarding insurance companies, revenue cycle operations and applications, and EDI/Clearing House it is important not to feel pressured to remain with Change as your business “goes down in flames” due to their issues and problems.
