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Change Healthcare Breach Shakes Hospital Revenue Cycles: CEO & Attorney Elizabeth Richards Calls for Cyber Contingency Plans

During the March 22, 2024, Episode of Deep Dive with Altum, CEO Elizabeth Richards engaged in a 30-minute discussion with attendees about the Change in Healthcare Breach and its ongoing repercussions on the Hospital Revenue Cycle. As you are likely aware, on February 21, 2024, Change Healthcare experienced the largest cyberattack in the history of United States healthcare. Because of their reach, processing 15 billion healthcare transactions annually, approximately one-third of healthcare transactions in the United States were affected. This breach instantly disrupted hospitals, doctors, insurance companies, and pharmacies, rendering them unable to access files, send bills, and receive payments.

The impact on Hospital Revenue Cycles, which rely on Change Healthcare for their clearinghouse services, has been severe. Even for hospitals or providers using alternative clearinghouses, there have been lingering effects due to the payers’ utilization of the Change Healthcare platform. Apart from the inability to submit claims, there have been significant delays in prior authorizations, payments, and remittances. Consequently, concerns have arisen about the delivery of care and the financial stability of providers who, in some cases, have gone unpaid for over 30 days.

This unfortunate situation underscores the necessity, as we learned in 2020 during the COVID-19 pandemic, for business leaders to anticipate and prepare Business Contingency Plans for such unprecedented threat scenarios. The term “Force Majeure,” which refers to unforeseeable circumstances that render contract performance impossible, became prevalent in discussions during the pandemic. Post-COVID, it became standard practice to include pandemic language in contract clauses, which were previously primarily reserved for natural disasters. This incident highlights the need to also incorporate Cyberattack language into these clauses, specifying that the attack may target the provider, the payer, and/or a third-party vendor.

Regrettably, payers have seemingly adopted the stance that clearinghouse delays are not their concern. The most effective way to address this is by including such issues in contract terms. Other considerations include outlining procedures for bulk submission of paper claims, extending timely filing and appeals deadlines, and establishing protocols for emergency claims management and approval.

Remember that the worst time to respond to a crisis is in the midst of it. Just as hospitals have Crisis Management Plans for various contingencies, there must also be fail-safe plans in place for the Revenue Cycle. Finance leaders must accurately assess and prepare for the potential scope of a Cyber Business Interruption and plan accordingly. Additionally, a system should be established to meticulously track and document all financial losses in such situations to facilitate claims with insurance carriers and/or legal action against third-party vendors.

A reoccurrence of another cyberattack is not a matter of if, but when. As we emerge from this crisis, let us heed these lessons and formulate a plan so that we may be proactive, not paralyzed, by the impact.

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Angela Goins, Public Relations Representative, Altum Healthcare Solutions
Angela GOINS

Public Relations Representative

Angela Goins is the Public Relations representative for Altum Healthcare Solutions and the owner of Angela Goins Communications, LLC, which specializes in the medical, legal, and public sectors.

With a passion for storytelling, Angela bridges the gap between organizations and their audiences, enabling them to forge authentic connections.

Angela holds an MA in Communications Studies from the University of Alabama and a BA in Speech Communication from the University of Georgia. After spending over a decade moving around the United States as an active-duty military spouse, Angela settled back in her home state of Georgia, residing in Canton with her husband and their four sons.

Matt Curry, Regional VP of Business Development, Altum Healthcare Solutions

Regional VP of Business Development

Matt Curry possesses 15 years of experience in healthcare revenue cycle solutions and currently serves as the Regional Vice President of Business Development for Altum Healthcare Solutions. 

Matt utilizes his extensive knowledge and expertise in healthcare revenue cycle and sales strategies to provide the best solution set for the company’s clients.

Outside of work, Matt enjoys playing golf and volunteering as a coach for multiple sports. He resides in Milton, Massachusetts, just outside Boston, with his wife and two children.

Kelsey Claster, VP Legal Affairs, Altum Healthcare Solutions

Manager of Legal Services

Kelsey Claster is the Manager of Legal for Altum Healthcare Solutions. She is a Kennesaw State University graduate with a BBA in Entrepreneurship and a minor in Information Systems. Kelsey began her post-graduate career with Altum in late 2021 and has quickly advanced herself by creating and implementing new practices that streamline our legal services.

Taylor Weaver, Complex Claims Manager, Altum Healthcare Solutions

Complex Claims Manager

Taylor Weaver is the Complex Claims Manager for Altum Healthcare Solutions. With over seven years of experience in healthcare billing and reimbursement, she brings a wealth of expertise to her role, specializing in handling complex claims with ease.

Taylor’s commitment to excellence and client satisfaction is evident in her work ethic and positive attitude. 

Taylor resides in West Georgia with her significant other and their two furry companions.

Meaghan Gildea, VP Operations, Altum Healthcare Solutions
Meaghan GILDEA

Chief Operating Officer

Meaghan Gildea is the Chief Operating Officer for Altum Healthcare Solutions. She brings a decade of expertise in Operations, HR, and Healthcare Law. Meaghan’s experience includes stints with major Complex Claims companies and Law Firms that conducted work on the entire Eastern Seaboard. Her expansive knowledge and work ethic are unparalleled in the healthcare industry.

Meaghan is a graduate of Georgia Southern University and Kennesaw State.

Mary Enge, VP Insurance Billing, Altum Healthcare Solutions

VP of Insurance Billing

Mary Enge is the Vice President of Insurance Billing for Altum Healthcare Solutions. With over 25 years of Healthcare Industry experience, she possesses a strong background leading teams in quality assurance and claims analysis for follow-up and claims denials for Medicare, Veterans Administration, Workers Compensation, Managed Care, Medicaid CMOs, and Medicaid.

Mary has collaborated with multiple hospital departments to resolve complex denials regarding authorization, medical necessity, COB issues, and assisted with various cleanup projects. She has worked closely with hospitals nationwide to assist in reviewing, analyzing, and resolving a high volume of accounts while maintaining great partnerships with her clients to ensure we always meet their goals and expectations.

Matthew ALFORD

Chief Development Officer

Matthew Alford serves as the Chief Development Officer of Altum Healthcare Solutions. Drawing on 15 years of experience in finance and Healthcare, his role is critical to our clients’ engagement, development, and satisfaction. Matthew believes in the importance of building relationships and delivering on measurables to increase performance for all of his clients.

A native of Cordele, Georgia and educated at Georgia Southern University, he currently resides in Fayetteville, Georgia with his wife and two children. Matt is an avid golfer who also enjoys serving his community as a church deacon and high school golf coach.

Elizabeth Richards, CEO, Altum Healthcare Solutions
Elizabeth Richards

Chief Executive Officer

Elizabeth S. Richards serves as Chief Executive Officer of Altum Healthcare Solutions. With 15 years as a Healthcare attorney, her expertise includes third-party liability, workers compensation, insurance appeals, Medicaid/Medicare, and other complex reimbursement matters.

Mrs. Richards is an active member of the Georgia Bar, Georgia Academy of Healthcare Attorneys, and Georgia Chapter of HFMA. As a member of Georgia HFMA, she has been on the board of directors, a legal counsel to the chapter, and co-chair of the Region Five event. Additionally, she chaired and founded the Women in Healthcare initiative in the state. In 2014, she was selected and served on the National HFMA task force for Early Careerist. She also holds the HFMA Fellow designation and the Medal of Honor.

She holds a Bachelor of Business Administration in Finance and a Juris Doctor, both from the University of Georgia. When not working, Mrs. Richards enjoys spending time with her two sons, Hudson and Grayson, and cheering on the Georgia Bulldogs!