How did Covid-19 affect Revenue Cycle Management Services?

The Covid-19 pandemic has taken many diversions from the beginning. It has affected healthcare industry in several ways. Though healthcare professionals are finding ways to deal with the pandemic, they are not yet able to manage their revenue cycle management services due to staff shortage. Since the pandemic started, it shook people with the fear of working together in a work space. Many office staff in most of the hospitals didn’t turn up to work because of tremendous spread of the disease.

Yet, facing many challenges, medical billing companies are lending their shoulders for healthcare professionals who are struggling to take care of revenue cycle management services in these terrible days. But there are few challenges that the companies as well as hospitals have to confront too. As the virus spreads, the healthcare industry is facing massive unemployment, not seen since the great depression. Financial uncertainties and issues with the medical supply chain in turn are making our efforts even less impactful.

Of course, there is a significant impact of the COVID-19 pandemic on medical billing for the community to contend with. In this article, let’s see how Covid-19 pandemic became challenging for revenue cycle management services and what impact it has.


Top Challenges of Revenue Cycle Management Services:

Ability to respond:

  • A permanent revenue cycle management department plays a vital role in keeping the hospitals and healthcare practices open for individuals during this pandemic.
  • Small healthcare practices are mostly uncertain if they have enough disposable income to respond to the demands of COVID-19.
  • During this effort, the Centers for Medicare and Medicaid Services had offered guidance on Covid-19 billing and the reimbursement opportunities that exist for healthcare professionals who are facing the uncertainty.

Billing and coding issues:

  • In an effort to make sure whether US healthcare organizations or hospitals, healthcare facilities and clinical labs are prepared to respond, CMS has released two Healthcare Common Procedure Coding System (HCPCS) codes that laboratories can use to bill for certain COVID-19 diagnostic tests.
  • Additionally, CMS has also released the guidance on billing while answering the questions about Medicare response and more.
  • The American Medical Association also announced the new CPT code that has been created to streamline novel Covid-19 testing offered by hospitals, health systems and laboratories in the United States.

Patient Responsibility Balances:

  • The Covid-19 outbreak is readily highlighting the issues of patient financial responsibility and surprise medical billing.
  • Healthcare professionals are a step forward in developing the collection strategies that make other cost-sharing arrangements to combat the present situation.
  • Insurance companies and healthcare providers are working together in order to decrease out-of-pocket costs for the patients seeking testing and treatment.
  • Healthcare organizations and healthcare leaders have also agreed and accepted an emergency spending deal that will authorize Medicare to waive geographical restrictions on telehealth.

Challenges Healthcare Professionals and Hospitals Confront:

Staff Shortages:

  • Healthcare professionals and hospitals are already dealing with staff shortage and are struggling to keep up with the demand surrounding COVID-19.
  • It has become a growing concern of hospitals and practices that do not have enough manpower or staff to take care of the increasing number of patients entering the hospital or clinic doors to get tested or seek treatment.
  • Healthcare workers are at the risk of exposure to the virus, along with mental and physical exhaustion that often result from the demand and intake of patients.

Lack of Hospital Infrastructure:

  • The overwhelming response to COVID-19 also impacts the healthcare system and the healthcare providers.
  • Hospitals and healthcare facilities are suffering from shortage of staff, beds, space, facemasks and other critical resources.  But all these issues compound to each other’s facility.
  • Healthcare workers and professionals are getting infected while treating patients with COVID-19.
  • In a way to help healthcare professionals and organizations, CDC has developed two checklists for patients with suspected or confirmed COVID-19. By determining how to allocate these resources in a way that meets the demand, it prevents halting operations which is a huge challenge.

Impact of Covid-19 Pandemic on revenue cycle management services:

New Tracking and billing updates:

  • Precise billing and tracking patient services ensure a better outcome in the form of potential flow of the revenue.
  • It’s very important and essential at this point of time, as healthcare professionals are facing enormous pressures to diagnose, treat, and provide follow-up care. It’s also significant to keep track of the updated codes introduced by government using revenue cycle management services.
  • A report from revenue cycle management services intelligence highlights new coding details during the novel corona-virus pandemic.
  • The International Classification Of Diseases including ICD-10 has been recently updated with a new code and healthcare providers now are ready to use U07.1, 2019-nCoV acute respiratory disease while diagnosing a patient with COVID-19.

Actions to reduce Claim Denial numbers:

  • With much of financial uncertainty, healthcare professionals must take further steps to decrease the number of claim denials.
  • An average of 5-10% of claims are rejected and denied every year. These claims can wind up costing $25 each to correct, so healthcare providers have a clear picture to reduce problematic claims.
  • Actually adopting a three part strategy will help to eliminate avoidable denied claims. Firstly, analyze the denials and audit data that helps to determine precisely where the errors are occurring.
  • It’s important to assign tasks to the most appropriate specialist on your team since certain types of claims tend to go to technical and claim denial specialists.
  • It’s more beneficial to assign claims by care setting or by a particular payer, since the revenue cycle management service team will become an expert on the special circumstances of each.

States Action against Surprise Billing:

  • One of the important problems patients and healthcare professionals are prone to during Covid-19 pandemic is surprise billing.
  • From their end, several states have already taken action to protect providers as well as patients.
  • Becker’s hospitals have revealed that “Connecticut adopted a policy to ensure patients are protected from incurring surprise medical bills for treatments provided during the pandemic.”
  • Others also reported that, “About 56% of Americans believe that their representatives must address the issue of surprise medical bills, based on figures from a 2019 tracking poll by the Kaiser Family Foundation.”

Anyhow, managing revenue cycle management services during these troubled times might be hectic for most of the healthcare professionals. Outsourcing your services can actually help you handle most of the billing and revenue problems.


Hope this article helped you in learning about how Covid-19 affects the revenue cycle management services. For further updates, please subscribe to our blog.


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