This past February, one of the largest clearinghouses in the country, Change Healthcare clearinghouse, sustained a cyberattack that resulted in an outage. This event jeopardized the processing of prescription medications for 67,000 pharmacies across the country. It is clear after this massive outage that clearinghouses need additional measures to ensure that medical claims continue to be processed undisturbed even in the event of a security breach. Without enhanced protection, healthcare providers may not get paid for their services.
One of the best ways to minimize the impact of future outages is to ensure redundancy in payer connections. This way, if a single system fails due to a lapse in security, the transaction will still be recorded and be able to be processed in another clearinghouse’s system. Therefore, millions of dollars of transactions will not be aged and delayed payments to providers will not be a concern.
This method involves linking several clearinghouses and their information to guarantee that payer requests can still be processed even in the event of a single clearinghouse failure. Establishing redundant systems for clearinghouses ensures that their vital information won’t be as strongly affected by hackers and payments to providers will be more protected against delays.
Source: Orbit Healthcare