Availity Processes $5B in Claims Stuck with Change Healthcare

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What You Should Know:

– The Change Healthcare cybersecurity breach continues to disrupt the healthcare industry three weeks after the initial incident. Hospitals, physicians, pharmacists, and health plans are struggling to maintain operations amidst logistical and financial challenges. Patients nationwide face uncertainty regarding their ability to receive necessary care.

– Availity, the nation’s largest real-time health information network, has emerged as a key resource in helping these organizations maintain critical operations.

Offering a Lifeline in a Time of Crisis

Within 48 hours of the incident, Availity offers its Lifeline support program, providing free digital connectivity for providers to exchange essential claims and healthcare information with health plans. This initiative has demonstrably mitigated the impact of the breach:

  • Over 300,000 Providers Aided: Availity has assisted more than 300,000 providers in navigating the disruption.
  • $5 Billion in Processed Claims: Availity has facilitated the processing of over $5 billion in claims that were previously stalled due to the Change Healthcare outage.
  • Rapid Onboarding and Increased Capacity: 51 health systems have already signed on to Availity’s Lifeline program, with more in the process. Availity has significantly expanded its processing capacity, handling a 40% daily volume increase (over 12.7 million claims processed in one day) without system disruptions.
  • Connections with Health Plans: Availity has connected more than 115 new Payer IDs, with 33 new direction connections with health plans and collaborating with industry associations to ensure streamlined access to electronic transaction platforms.

Availity Lifeline Services

Availity offers streamlined digital pathways to send and receive key transactions, including eligibility and benefits, claim status, claims, remittance advices, and EDI batches. Availity has created dedicated websites offering resources to help impacted organizations establish alternative electronic transaction options compatible with their existing EHR systems. Self-service options and live assistance are available.