Clearinghouses are platforms that allow data transfer between providers and payers and are vital parts of the larger healthcare system. However, clearinghouses face challenges, such as cyberattacks. For example, the Change Healthcare clearinghouse recently suffered a sustained outage due to a cyber attack. As a large clearinghouse, Change Healthcare handles 15 billion healthcare transactions in the United States every year, this outage has significant consequences.
More specifically, when medical claims cannot be submitted, millions of dollars in transactions are aged because they cannot be paid and fulfilled. This leads to larger financial gaps until the problem is resolved.
Luckily, there are ways to reduce the risk of outages. Payer gateway connection redundancy is a useful tool. In order to achieve this redundancy, multiple clearinghouses need to communicate with each other, establishing backup systems. This decentralization ensures that, even if one clearinghouse suffers an outage, the others can pick up the slack and maintain the transfer of data.
Outages pose significant threats to clearinghouses, but there are ways to mitigate this risk. Boosting redundancy can go a long way in maintaining stable systems, and should be prioritized moving forward. With this implementation, the next cyber attack won’t be such a risk.
Source: Orbit Healthcare