The healthcare industry has seen an explosion of treatment options and delivery methods as consumers gravitate towards convenience and accessibility. One big reason is cost. Accessing care in an urgent or emergency care center is far less expensive than a traditional hospital-based emergency room. As more consumers opt for High Deductible Health Plans (HDHPs) to cope with rising premiums (thereby absorbing more responsibility for the financial costs of care), urgent and emergency care centers, have further increased in popularity.
Coupled with a long-term trend—a vast majority of healthy people see establishing an ongoing relationship with a primary care provider as unnecessary. For this group, urgent care centers are used in place of an established provider for the occasional illness or injury.
The Impact of COVID-19 on Urgent and Emergency Care Centers and Their Business Operations
As the country and the healthcare system began navigating the ongoing COVID-19 pandemic, urgent care and emergency care centers were impacted early on as they were flooded with patients seeking testing and care from suspected coronavirus symptoms, as well as patients who couldn’t access their regular providers that had closed their offices. Taking guidance from the CDC and the Centers for Medicare and Medicaid (CMS), many ambulatory centers were able to absorb the influx of patients, but have been faced with overwhelming operational issues to ensure reimbursement from insurance payers.
- Real-Time Insurance Verification—Whether providing telehealth services or physically seeing patients on-site, patient demographic information, as well as insurance verification and benefits eligibility, still must be collected and processed. Especially in an ambulatory setting, where there is no long-term relationship or history, it’s critical that insurance verification is expedited electronically through an automated solution so that reimbursement can be obtained in real-time, as well as proper patient portion collections.
Coding and Billing—Quickly scaling up to absorb the growing claims that need to be processed is challenging enough, but couple that with staying up to date on ICD-10-CM and CPT coding requirements for COVID-19 and coronavirus, it can seem impossible. Partnering with third-party coding and billing experts, like Infinx, could be the answer to fast processing and clearing any log jams that are overwhelming your staff, or lack thereof.
Equally important, is preparing or positioning urgent and emergency care centers for the post coronavirus influx of patients that is expected—those that had milder symptoms or toughed out an injury waiting for the stay-at-home orders to be lifted in their communities.
Aging AR Optimization—The first thing that is usually neglected during a large influx of business are the aging ARs! It seems easy to ignore troublesome claim denials, outlying amounts to be collected, and collections follow-up, but that is literally uncaptured revenue. The risk claims being uncollected grows as the further out it ages.
By engaging a third-party partner now, like Infinx, there is an opportunity to leverage artificial intelligence and (AI) automation to predict, prioritize, and recover outstanding 3rd party aging AR revenue, while increasing the bottom line and eliminating write-offs. By partnering with Infinx, you’re able to scale without the need for additional staff, and doesn’t negatively impact your business cycle or bottom line.
Urgent and emergency care centers are uniquely positioned to fill the growing demand for easy access and affordability. With the field becoming crowded by retail, pharmacy, and insurance companies offering on-site clinics and wide coverage, negotiated fees will become more competitive in the future. With streamlined business solutions available today during these uncertain times, centers can be positively poised for months to come as well.
Learn more about our ability to quickly scale up to meet your immediate needs.