The recent cyberattack on Change Healthcare has spotlighted the need for improved systems in insurance and care delivery, according to Bertram Hughes, DMD.
Change Healthcare, a revenue cycle management subsidiary of UnitedHealth Group's Optum, was hit with a cyberattack that has been ongoing since Feb. 21. The cyberattack is affecting dental, medical and pharmaceutical companies, including dentists' abilities to process claims, the American Dental Association said Feb. 27.
The federal government has launched an investigation into UnitedHealth Group following the cyberattack, which the American Hospital Association called "most significant cyberattack" on healthcare in U.S. history.
Dr. Hughes, of Family & Cosmetic Dentistry in Gainesville, Fla., recently spoke with Becker's about the impact the cyberattack will have on the dental industry.
Editor's note: This response was lightly edited for clarity and length.
Question: How has the Change Healthcare cyberattack affected your practice operations? What impact do you think this will have on the dental industry?
Bertram Hughes: The Change Healthcare data breach has had a profound impact on the entire dental industry. While my office personally has reserves to cover this disruption, our funding cannot last for an extended time without some sort of resolution. We have been using some of the insurance company's internal systems to file claims. This, however, is more staff time and compensation while being reimbursed at insurance-imposed reduced payments. Not all insurance companies have an internal claims process. Actually, most do not, thus they rely on a clearinghouse.
As with the COVID-19 disruption, the insurance industry stands to profit off this cyberattack. It is important to note some in the insurance industry help set up and, for the most part, control the clearinghouse system. Each insurance company is perfectly capable of providing much needed compensation to the dental offices using innovative approaches. One of these thoughts could be using estimated monthly reimbursement averages to help some of the offices that need the monetary relief.
In addition, the dental software companies may have some responsibility in ensuring its clients' submitted claims are adjudicated in a lawful, timely manner. The software companies' responsibility lies in making sure the sent claims are received by the insurance carriers for processing. Unfortunately, some software companies are using this opportunity to market new or existing products to dental offices. Some view the timing of their efforts as poor taste. The added services they are marketing do not appear to have any added benefit for avoiding the current cyber issue.
The nation as a whole probably needs to start addressing the many issues surrounding the insurance market in healthcare. The way we deliver healthcare in the U.S. is ripe for innovation. I believe, with the advances in technology, the public will begin seeing better options for dental care delivery. Currently, the insurance industry does not have any incentive to improve the system currently in place.