EDI Services Restoration Update - March 1, 2024
To Every Unlimited Systems Client Leader:
This week marked an important transition in Unlimited’s support to our customer community – from identifying the most practical ways to provide immediate resources to your business office to the now hard-running marathon of restoring EDI services at scale without dependence on Optum/Change Healthcare. Our mid-week national webcast described the introduction of an EDI Software Switch and the redirection of claims from Change Healthcare to an Availity pathway.
Here are the most significant takeaways for our practice executives, revenue cycle leaders, and engaged client staff:
“Lifeline” Claim Submissions have started for all Unlimited Systems customers. Prior to activation of the EDI Software Switch our engineering team implemented partial automation to redirect claims to Availity for a subset of the most significant commercial carriers who do not require payer-specific enrollment. The Lifeline mechanism will be retired within the next several days as soon as the Switch is meeting Production EDI requirements for all customers. There is nothing you need to do to be included in the Lifeline process.
Registration for the EDI Software Switch is underway across Unlimited’s customer base. As of this time, more than 75% of customers have completed and returned Switch Registration documents. Our Claim Advocates continue to drive the personal outreach, education, and support to ensure timely awareness, approval, and utilization of the Availity Gateway.
An FAQ summarizing and responding to customer questions submitted during our national webcast on Wednesday, 2/28/2024 is available via our website. The fact that several dozen independent questions could be answered with just fourteen distinct responses indicates the degree of converged interest across our clients. The same strength in numbers that enabled expedited introduction of the Availity pathway continues to manifest throughout this period. Both the FAQ and a recording of this week’s webcast are available at: unlimitedsystems.com/edistatus.
Unlimited Systems continues to support the Community Oncology Alliance’s escalated request that CMS provide temporary relief from the EDI enrollment paperwork and associated lead times required when practices access new Claims and Remittance pathways. COA’s Board representatives met this week with Jonathan Blum, Principal Deputy Administrator & Chief Operating Officer for CMS, as well as some White House staff, to address the impact of Optum’s service outage. A successful outcome will accelerate restoration of Medicare claims filing by a few weeks for all customer practices, regardless of specialty.
Given the Optum division’s inability to provide an estimated time to restore the Change Healthcare Gateway, UnitedHealth Group is evaluating whether/how to extend their Optum Pay lending facility on preferred terms to Change Healthcare customers. Although the economic value of this potential support remains undefined, Unlimited Systems has provided Optum with a roster of its Change Healthcare customers to support your inclusion in whatever resource UnitedHealth Group provides. We will share any future updates on this topic directly with you.
Our collaboration with you is powerful and we are relentlessly focused on scaling the positive impact of Lifeline services, our EDI Software Switch, and the Availity pathway.
