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.
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.