redundant healthcare payer systems

The Impact of the Change Healthcare Clearinghouse Outage

The recent cyber attack on Change Healthcare’s clearinghouse, responsible for processing approximately 50% of medical claims in the US, highlighted the critical importance of payer gateway connection redundancy. With medical claims for about 900,000 physicians affected, the outage disrupted the backbone of healthcare payment processing in the nation. Clearinghouses serve as vital platforms facilitating data transfer between healthcare providers and payers, essential for ensuring timely payment in the industry.


Importance of Payer Gateway Connection Redundancy

The impact of the attack extended beyond medical claims, affecting the billing processes of over 67,000 pharmacies and handling a staggering 15 billion healthcare transactions annually, equivalent to one in three US patient records. To mitigate such risks, building payer connection redundancy is essential. Establishing communications with multiple clearinghouses, each built on modern architecture and highly scalable is crucial for ensuring operational continuity during outages.


Strategies for Building Redundancy in Healthcare Payment Processing

Decentralization emerges as a key strategy, as relying solely on a single clearinghouse poses significant financial risks due to delayed payments and unfulfilled transactions. By communicating with multiple clearinghouses, healthcare systems can effectively navigate through potential disruptions and maintain seamless payment processing even amidst cyberattacks or system outages.


A New Approach 

Some healthcare companies highlight the proactive approach to protect payment processing integrity, so it is important to find the right one. In today’s landscape of increased cyber threats, having redundant healthcare payment processing systems is not just a precautionary measure but a necessity to uphold financial stability and operational continuity in the healthcare sector.


Lessons Learned from the Change Healthcare Cyberattack
Source: Orbit Healthcare