Will Your Claims Get Through Despite the Disruption?

Posted by Smart Data Solutions on March 1st, 2024
Smart Data Solutions

Addressing Concerns and Providing Clarity to Health Plans and TPAs

In the wake of the recent cyber security incident, the healthcare industry finds itself at a critical juncture. The cyberattack has disrupted vital transaction flows between providers and payers. The repercussions have been swift and severe, with claims and remittances grinding to a halt, leaving impacted entities scrambling for solutions.

As healthcare professionals, we understand the frustration and uncertainty this disruption has caused. Paper claim and remit volumes are on the rise temporarily, adding an extra layer of complexity to the existing system. However, amidst these challenges, Smart Data Solutions has been handling electronic and paper processes and is processing as usual.

Frequently Asked Questions

As providers and payers seek workarounds and alternative EDI pathways, Smart Data Solutions (SDS) has been diligently addressing these crucial questions. This comprehensive FAQ aims to provide clarity on alternative pathways and implementation processes. Our goal is to equip you with the necessary information to navigate this disruption effectively.

1. What proactive measures has SDS taken to safeguard its customers and their data in response to this cyber incident from a security standpoint?

In response to the incident, SDS promptly ceased all interconnections to Change Healthcare’s platform as a proactive measure to prevent potential harm, including file transfers and portal accounts. Additionally, we conducted a thorough examination of our internal systems and ensured that there is no impact on our network. SDS maintains ongoing communication with Change Healthcare and its parent company, Optum, to stay abreast of the latest updates and guidance.

2. Can we anticipate a surge in paper claims and remittances as a result of the cyber attack?

The likelihood of an uptick in paper billing as an alternative during periods of electronic billing unavailability is high. However, we anticipate this surge to be temporary. Notably, SDS is well-positioned to handle this increase. Our automation and AI platform’s scalability supports our ability to manage the influx effectively.

3. How is SDS assisting payers and providers in re-establishing connections following the recent cyber security disruptions?

Here’s how we’re supporting payers to swiftly re-establish connections through our clearinghouse:

4. Will I need to set up a new payer ID?

No. You may use the same payer ID currently listed on member cards.

5. Is it mandatory for providers under a health plan to register with SDS as a clearinghouse?

No, providers are not obligated to sign up with SDS as a clearinghouse. They retain the flexibility to continue using their existing clearinghouse services. In the event of disruption, SDS collaborates with our extensive network of trading partners to ensure seamless redirection of claims. However, if a provider is unable to bill due to the outage, registering for a clearinghouse account with SDS is a straightforward process. Simply visit https://portal.smartdatastream.us to begin.

6. Is it necessary to inform my current clearinghouse to redirect claims through SDS?

No notification is required. SDS will seamlessly add your payer ID to our list, indicating to our trading partner network that we can accept claims on your behalf and efficiently deliver them to you.

7. Can SDS send 835 remittances to my providers?

Certainly. You have two options: you can provide your remittance enrollment data to SDS for us to start routing and delivering 835s promptly. Alternatively, providers can re-enroll for electronic remittance through the Smartdata Stream provider portal – https://portal.smartdatastream.us.

8. What is the accelerated setup process like and how long does it typically take?

Our accelerated implementation at SDS is designed to be exceptionally swift, often completed within just one week, provided that all teams involved are responsive during the 837-integration phase. This accelerated process ensures basic SNIP-validated 837 delivery, with the flexibility to incorporate more advanced payer edits at a later stage if desired.

Need support or have questions? Fill out the form here, and a Smart Data Solutions representative will get in touch with you promptly to offer guidance and assistance.




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