Summing It Up

Protecting your Financial Health: Considerations for Insurance Claims and Litigation Related to the Change Healthcare Cyber-Attack

Written by Freed Maxick Healthcare Consulting Team | Mon, Mar 11, 2024 @ 07:51 PM

The cyber-attack on Change Healthcare has severely impacted healthcare providers' financial operations, disrupting claims processing, billing, and prescription services, and putting patient care at risk.

With services interrupted, providers face financial strain and have an urgent need for relief. Short-term aid could include advances and government support while potential long-term strategies could involve business interruption claims and litigation.

Regardless of the source of relief, it is critical that providers act now to maintain complete, accurate and contemporaneously documented data regarding the impact of outage on their businesses. If your organization has business interruption insurance or is considering filing a claim against Change Healthcare, having the right information is vital. It lays the groundwork for your claim and prepares you for a streamlined claims process. To gain insights into the essential data you should collect now, watch our webinar recording. We explore important considerations and steps you can take now to safeguard your organization’s financial interests:

  • Review all your contracts with Change Healthcare. Ensure you understand any indemnification provisions Change Healthcare may have committed to with your organization. Given the variety of services provided, you may have multiple contracts with Change Healthcare, each with different legal recourse. Consult with your legal counsel for guidance.
  • Obtain, review and understand the coverages and limitations of your business interruption insurance policy.
  • Evaluate your organization’s exposure to other entities due to the Change Healthcare outage. If your organization is unable to fulfill its obligations as a result, assess your contractual commitments to your customers and understand your potential exposure.
  • Thoroughly document the nature of the interruption and its effect on your organization’s business from the start date, noting the daily effects the interruption has had on your operations.
  • Prepare detailed “proof of loss” and/or document “damages” and “expenses” associated directly and indirectly with the event. Suddenly transitioning to a new clearinghouse or billing solution involves significant added costs for technology, training, consulting, and legal fees, plus potential for lost revenue from revenue cycle down time. Your documentation must be robust and well-supported to pass scrutiny from claims adjusters, defense counsel, or both. With potentially hundreds if not thousands of related claims and lawsuits, well-documented and supported claims are more likely to be fully compensated.

The financial impacts associated with this event extend beyond the direct costs associated with event response and lost cash flow, impacting many areas of provider financial health. The Freed Maxick healthcare team has experience working through similar events and can help your organization identify all impacts to maximize any recovery or support. Our expertise in compiling and reporting data for submission to insurance carriers or others enhances your submission , increasing the probability of success and accelerating the approval process for any support application.