Moffitt Cancer Center was one of many health systems impacted by the Change Healthcare ransomware attack earlier this year. The organization’s VP of revenue cycle managment explains how she navigated the disaster.
Seven months after the Change Healthcare cyberattack, things seem to be back to normal, but healthcare organizations are moving with caution. The ransomware attack was a significant blow to the sector, preventing providers from collecting or receiving payments or checking a patient’s coverage.
Among those affected was the Moffitt Cancer Center in Tampa, Florida. HealthLeaders spoke with Lynn Ansley, vice president of revenue cycle management and a HealthLeaders Exchange member, to discuss how she guided her team and redirected their processes.
HealthLeaders: What was the first sign that something had happened?
Lynn Ansley: Our teams logged in like any other normal day and they were unable to access a lot of our key systems to get our technical claims out the door. Our technical clearinghouse was down, and that’s about 90% of our revenue.
The second piece, which we identified later that day, was that our patient payment platform was down, so patients were also unable to make payments. The system was completely inaccessible to both our patients and our team members to be able to collect payments.
HL: How did you organize your team to move forward?
Ansley: The most important thing that I could do that day was to, first, gather the facts. The scary part for me, and I'm sure for every revenue cycle leader across the country that was impacted, was we didn't have any information. We didn't know if it was an hours-long outage or multiple-day outage.
It didn't take long for us to learn, based on what our cybersecurity team was telling us and what they were hearing from others in the industry, that this was going to be a substantial outage and we needed to act.
I looked at it like this: We needed to find a way to be able to pay our team members. So that first day, we're not just trying to get claims out the door; we're trying to be able to make sure that we can get cash in the door so we can pay our 9500 team members.
Last year, we rolled out like our new organizational purpose, which is framed around positivity and John Gordon's The Energy Bus. I think the universe gave us a little bit of a gift in this, because we really took that positive momentum and we just charged forward.
That took me as the leader, making sure that other areas in the organization were leaning in to help, but also that I was willing to do the work. Willing to roll up my sleeves and really be in the trenches with my team to figure out what those interim solutions were going to be and just maintaining that ‘we can do this’ attitude.
HL: How long did the outage last for Moffitt?
Ansley: We were using an alternate clearinghouse about three weeks later, and [we were] able to set up our new solution and then mature and refine it over time. But during that three-week period, we really got creative.
We were down in terms of having a clearinghouse or an interim solution. We started manually keying in claims about a week and a half later, going into direct data entry and key-stroking in an inpatient claim, which can take about an hour on average.
We had managers, supervisors, and team leads going into these systems that they haven't used for this sort of work in many years, relearning the system overnight, and coming up with ways to prioritize the work so we could at least get some claims out the door.
Parallel to that, we had our operational IT team and revenue cycle systems IT team looking at other solutions.
We were doing a lot of trial and error to try to figure out how to get more than one claim through at a time. Even though we could get claims out the door, we had to get the remittances in the door and figure out how to post the cash because we didn't have our traditional workflows for getting our electronic remittance advice—which tells us what they're paying for and what patients they're paying for.
This is part one of a two part story.
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Jasmyne Ray is the revenue cycle editor at HealthLeaders.
KEY TAKEAWAYS
The Moffitt Cancer Center was unable to access a number of its key systems, along with its clearinghouse—which managed 90% of its revenue.
In times of crisis, RCM leaders must exemplify a calm and rational attitude to guide their teams toward a solution.
The organization moved quickly to redirect digital or automated workflows so that they could complete them manually.