CASE STUDY
Health system restores claims processing 8 days after
cyberattack.
Rapid response stabilizes patient access operations + reimbursements, ensuring financial resilience.
SNAPSHOT
Less than 120 days into our partnership with a nonprofit health system, Ensemble provided significant assistance after the system was impacted by the Change Healthcare cyberattack. This attack disrupted not only its claims management but also its cash posting, real-time eligibility, estimations and medical necessity processes.
Claims processing for key payers was restored through a new clearinghouse in just eight days, significantly faster than the typical 90–120 days required for implementation. Over $40 million in cash was manually posted during the recovery, with automated systems implemented by the second month to restore operational efficiency. Within 90 days, monthly claims volumes reached $450 million, exceeding pre-attack levels.
With Ensemble’s support, provided at no additional cost, the system was able to avoid external loans during the transition period and maintain financial stability throughout the disruption.
PROFILE
- Nonprofit community healthcare system
- < $1B NPR
- Southeast region
- End-to-end RCM partner
Challenges
The cyberattack on Change Healthcare in February 2024 significantly disrupted the operations of a nonprofit health system. Due to the deep integration of Change’s systems within the organization, challenges arose in not only managing claims processing but also cash posting, eligibility verification, estimations and medical necessity workflows.
Impacts on front-end systems necessitated temporary workarounds to sustain point-of-service collections and patient access operations during the extended outage. Manual processes became necessary to maintain essential functions, which strained resources and increased the risk of financial instability. This situation also had the potential to affect the patient experience and the system’s reputation within the community it served.
Solutions
Less than 120 days into the partnership, Ensemble provided swift, expert-driven solutions that stabilized operations and safeguarded financial performance. Our focus was on reconfiguring workflows and financial continuity while restoring core systems. This support was offered at no additional cost, underscoring our dedication to partnership and ability to perform under pressure.
Ensemble helped by:
- Establishing rapid clearinghouse transition, initiating clearinghouse discussions within 24 hours and coordinated with SSI, IT, billing and delivery teams to enable claims submission for key payers in just eight days, an effort that typically takes three to four months during standard implementation.
- Manually processing claims + rebuilding workflows during the initial recovery while reconfiguring workflows to ensure accuracy and timeliness. This foundational work enabled a phased expansion to additional payers over the following 90 days.
- Automating cash posting tables within the host system to fine-tune and resolve issues related to double postings and credit balances that were previously automated and fully operational across payers, completing more than $40 million in manual postings within two months to ensure stable cash reserves.
In times of crisis, real partners don’t hesitate — they help. We stepped in to support our client not because it was required, but because it was right. That’s the difference between a vendor and a partner.
Results
to submit claims to specific payers
to track above $350M baseline
within 2 months of attack