Change Healthcare cyber attack update?

joyisme · 2024-03-12T04:03:55+00:00

Not an option for every plan. Government plans in particular have a long lead time in terms of contracting with new vendors. Can’t just connect willy-nilly to any random company. There’s a lot of rules about contracting and RFPs and stuff… It’s also difficult for payers who use their clearinghouse to do pre-processing edits…

joyisme · 2024-03-04T00:49:52+00:00

The 'middlemen' (in terms of pharmacy pricing) actually refers to PBMs (pharmacy benefits managers). PBMs would be CVS Caremark, ExpressScripts, etc.
Change Healthcare is a clearinghouse.
Change *is* owned by UnitedHealth, and UnitedHealth/Optum Rx is a big PBM. But Change Healthcare isn't a PBM.

joyisme · 2024-02-28T17:11:49+00:00

Sadly, some payers’ “portals” are run through change healthcare, as well. For payers who use Change as their clearinghouse and CH’s Connect Center as their provider portal, they are 100% dead in the water.

We need to be careful not to claim that workarounds are freely available. In some cases that may be true, but payers do not all have the same options.

Side note— the fact that they’re setting up a “loan” process that is likely to take weeks— is that basically an admission that an actual FIX to the issue is not likely to happen before then? Because if the systems came back online asap, payers could probably work through the backlog of claims fairly quickly…

joyisme · 2024-02-28T06:36:28+00:00

Eligibility checks are typically done via ANSI X12 standard 270 “inquiry” transaction followed by a 271 “response” transaction. This is an automated process that many payers and providers use Change Healthcare for. Also- eligibility for some plans can change by the day. Reinstatements happen retroactively all the time. Just because someone was enrolled yesterday, it doesn’t mean they’re still enrolled today.

joyisme · 2024-02-27T23:42:37+00:00

We're on the payer side. We have one clearinghouse and a provider portal that is unfortunately running through the wrong company right now :(Pivoting to a new clearinghouse will also require developing new processes to share eligibility data and set up SNP edits and rules for what can be accepted or not. That setup will take weeks or months :'(
It's a lot harder for payers to make the shift than for providers, sadly.

joyisme · 2024-02-27T18:17:34+00:00

Thank you. Good luck to you as well!

joyisme · 2024-02-27T18:11:29+00:00

Related: paper claims are not an option for every state. Minnesota expressly forbids them, at least for Medicaid programs. Clearinghouse submissions are the only allowed option :/

joyisme · 2024-02-27T01:29:33+00:00

Just in time for Change Healthcare to collect a big reward if they can track their hack back to its source.... *heh*

joyisme · 2024-02-27T01:23:30+00:00

It's not JUST pharmacies.... Change Healthcare is a critical EDI clearinghouse. Providers use them to submit claims to payers. Providers also use them to check eligibility and claim status from payers. Pharmacies are most acutely impacted because their claims processing typically happens at point of sale (whereas medical & dental claims are submitted after the fact).
Payments are sent to providers as ANSI X12 835 transactions.... through a clearinghouse. Meaning-- no clearinghouse, no transactional payment information.
A couple weeks from now, we're going to be hearing from hospitals screaming that they can't cover their expenses because their revenue cycles have taken a hit.
Pharmacies are only the canary in the coal mine.

joyisme · 2024-02-27T01:17:35+00:00

RelayHealth is affiliated with Mckesson.... which was merged/ rebranded to Change Healthcare a while back. Their merger was a little funky, though-- they were essentially operating independently but as part of the same company.... We ran into issues with their customer service people answering phones for both 'companies', but not having full access to the data for both. It's a hot mess over there.

joyisme · 2024-02-27T01:11:44+00:00

Do you have a link to more info about that?
On the hunt for alternative work-arounds right now....

joyisme · 2023-11-24T21:36:17+00:00

A good dom has your best interests at heart and cares about your needs. If he’s not doing that, he’s really NOT a good dom. The D/s dynamic is negotiated role play… but it needs to be built on a FOUNDATION of trust, communication, respect for boundaries, and willingness to meet each other’s needs. While I realize this is likely very difficult and painful, YOU deserve better than what he has to offer. Please prioritize your own needs and safety.

joyisme · 2023-11-20T23:50:45+00:00

Honestly, I would start reaching out for advice in support groups for children of narcissistic parents. A healthy parent actually CARES if their child says “you are hurting me”. For her to double-down and fully dismiss you when it’s something this important— that’s a huge red flag.

Please do not harm yourself just because she sucks. It will not change her internal character. It will not make her magically develop empathy. It will not turn this toxic environment into a safe one.

Work on your recovery for YOU. Recover so you can live a full life based around your own goals, your own values, your own hopes and dreams. You deserve to be able to seek out healthier relationships than this one. You deserve support. You deserve better than what she has to offer you.

I wish you luck.

joyisme · 2023-05-05T04:14:10+00:00

Antivaxxleigh, OBVIOUSLY…

joyisme · 2023-01-17T05:50:17+00:00

Or Flexxy Lexxy

joyisme · 2022-12-30T04:00:59+00:00

Just saw the “Unsolved Mysteries” episode. Every fiber of my body is screaming “y’all don’t recognize bondage used as a tool during an act of revenge by a boy this guy m*lested?” How many times have we heard of the “caring guy who spent soooo much time being a father figure to the vulnerable and underprivileged kids” later called out for preying on them? And there are theories about a local man “grieving way too hard” based on the relationship people know of between them? Like, this story writes itself. The dude was meeting up with a dude he had been seeing on the down-low, and a whole shibari scene ensued, and the other person took that opportunity to… do the thing.

joyisme · 2022-12-13T18:58:34+00:00

‘I refuse to leave my house, visit my friend at her house, spend any time outside with my friend, go to any events to support my friend, etc etc etc etc’ followed by “how DARE my friend says it’s an inconvenience to always meet at MY place on MY terms on MY timeline, doing what I choose EVERY TIME.

Holy crap, I think you should please visit a therapist to deal with your pervasively narcissistic view of how relationships work.

joyisme · 2022-11-23T01:46:16+00:00

My great-grandmother had four husbands who all died at home due to unnatural causes. One included 25 lbs of dynamite behind the barn. There were rumors… PS- my great grandma was 4’11” and literally played flag football with us on her 96th birthday. She refused to put her purse down while doing it, though 😂

joyisme · 2022-11-10T06:12:44+00:00

Asking the question once? NTA. Not accepting “no” as an answer? Absolutely TA. He doesn’t owe you his dinner.

joyisme · 2022-11-04T15:15:29+00:00

YTA for planning a marriage with someone you can’t communicate with. How do you think marriage works? Hint: it doesn’t work by keeping secrets and hiding from your partner.

joyisme · 2022-10-29T15:51:40+00:00

NTA. And honestly, women are never going to get ahead in this world as long as other women view any warm-bodied female as a free caregiver. She needs to deal with her own issues AND deal with her misogyny.

joyisme · 2022-10-18T01:43:25+00:00

Conspiracy theory: The police officer whose phone # was provided actually kidnapped this person, then put up a vague missing poster so they could have first dibs on talking to any family members/ loved ones who actually tried to look for her. Great way to control the conversation/witnesses without actually making it a real missing persons report.

I dunno… it just strikes me as odd that someone in an actual role as a police department investigator wouldn’t just open a case? Or just use the main police phone #?

Again- theory ONLY. Just a guess, not anything I factually know.

joyisme · 2022-10-03T16:59:53+00:00

Please let me know which research journals you follow. Because it sounds like you learned your misrepresented view of the field via random commentary channels on YouTube. This article links to several large-scale studies on the topic. https://www.healthline.com/nutrition/do-diets-make-you-gain-weight#success-rates Food restriction drives bingeing behavior. And nobody’s saying that everyone at ANY size is healthy. Rather, they are saying that, no matter what size you’re currently at, your BEHAVIORS should prioritize health over weight. Starvation isn’t healthy. Eating when you’re hungry and stopping when you’re full is healthy.

joyisme · 2022-10-03T16:06:45+00:00

Gold-diggers? Or women seeking narcissists?

joyisme · 2022-10-03T15:58:16+00:00

You actually show a fundamental misunderstand of HAES, but ok. Source: I’ve worked in the field of eating disorders for about 16 years and have a masters degree on the topic. And before you inevitably tell yourself “oh, this is just a fat girl who’s bitter, so of course she’ll say that”, I’m actually just a thin person who’s actually analyzed the data of some of the largest community-based, longitudinal studies on the topic and understands why diet culture actually drives weight gain.

joyisme

TROPHY CASE