Highmark assisting medical practices affected by cyber attack

Highmark Healthcare launched an assistance program Tuesday to provide funding advances for medical providers experiencing cash flow concerns due to a cyber-attack rendering them unable to submit claims. 

UnitedHealth Group’s Change Healthcare and its impacted companies was a victim of a cyber-attack by a ransomware group known as ALPHV or BlackCat in late February.  

The company had to shut down its electronic portal keeping medical practices from submitting claims and communicating with pharmacies for prescription deliveries. 

Kate Musler, senior vice president of Health Plan Risk Management and Provider Networks, said Highmark’s focus has been to pay claims as quickly as possible to allow medical practices to continue to operate. 

The advance payments are estimated on the historic volume of claims Highmark receives from each practice, she said. 

Highmark is the only Blue Plan in Central Pa. offering the service, Musler said.  

UnitedHealth Group, in an update on its website, said it continues to make substantial progress in mitigating the impact to consumers and care providers of the unprecedented cyberattack on the U.S. health system and the Change Healthcare claims and payment infrastructure. 

“We are committed to providing relief for people affected by this malicious attack on the U.S. health system,” said Andrew Witty, CEO of UnitedHealth Group. “All of us at UnitedHealth Group feel a deep sense of responsibility for recovery and are working tirelessly to ensure that providers can care for their patients and run their practices, and that patients can get their medications. We’re determined to make this right as fast as possible.” 

Highmark said eligibility for assistance and amount of assistance will be determined based on a variety of factors including inability to use an alternate method to submit claims and current financial need. 

“We understand that some smaller physician practices and other providers who have been affected by this cyber event have not been able to submit claims and are facing financial hardships,” Musler said. “This assistance program will help those providers get through this disruption and will also help ensure that our members can continue to access care and utilize the benefits they deserve.” 

Musler said Highmark began immediately creating the advance payment option upon hearing about the security breech.  

“It’s not easy to say we’re giving advances. It’s not something we do. We pay claims,” she said.  

But after noticing a drop in the volume of claims, Highmark realized some practices would need payment to continue serving patients while the issue is resolved. 

Once claims can be submitted, Musler said they will be processed and paid. The recipient will then have a window of time to repay the advances. 

“Providers don’t want advances because it’s administratively challenging, so they are working to find alternate ways to get claims to us,” she said. “We opened capability in our portal where they can download a spreadsheet and then upload it back to the portal.” 

Musler said the lifeline product, Availity, can be accessed through the Highmark portal. The patch, as Musler called it, can be installed and up and running in a few days to a week, she said. 

“We are opening as many avenues as possible to help pay claims,” Musler said. 

Nearly 2,000 clients are still impacted by the shutdown. Musler said because of insurance regulations, self-insured policies can’t receive advanced payments, but all fully insured plans can.