As COVID-19 came hurtling into our existence, healthcare experts were grappling with value-based care initiatives, consumerism, and the changing landscape of reimbursement and care delivery. Mid-way through the crisis, the focus has turned to more immediate issues like testing and care for COVID-19 patients, as well as non-impacted patients, absorbing new telehealth guidelines, and managing an overworked and exhausted workforce.
In time, we will no doubt return to these overarching issues, but for now, maintaining the pace and figuring out how to be paid for the work done are top priorities. To be sure, this has been (and continues to be) challenging, but it’s also a great time of opportunity to rethink the status quo.
3 Revenue Cycle Issues that Deserve Creative Consideration
Looking out into the not too distant future, we see three areas that will benefit from the creative examination. Fundamentally, being open-minded and willing to adapt and test solutions may lead to improvements that will extend way beyond the current crisis and impact the healthcare revenue cycle for years to come.
A recent research brief by the non-profit consumer organization FAIR Health, dated March 25, 2020, estimates the overall costs for treating the COVID-19 outbreak in the US will exceed $1.4 trillion and could be much higher. While the Centers for Medicare and Medicaid Services (CMS) and most commercial insurance carriers are waiving copay fees for testing and care of COVID-19, the economic impact is projected to be massive long term including rapidly escalating insurance premiums and tax increases.
Hospitals and providers’ best protection in these times of uncertainty is to ensure that they are using the most advanced automation applications for insurance verification and benefits eligibility, as well as patient pay estimation solutions that provide patients with real-time cost estimates. These automated processes accurately applied would help to reduce bad debt, which is expected to grow significantly.
Additionally, an artificial intelligence (AI) driven insurance discovery solution would allow hospital systems and providers to utilize vast clearinghouses of eligibility information to identify undisclosed insurance coverage. Especially useful with Medicaid and commercial insurance payers, insurance discovery allows outstanding bills to be collected without having to involve a collection agency (or pay the fees required).
Postponed Elective Procedures and Routine/Chronic Care
There will undoubtedly be a flood of patient care coming in the months ahead. From postponed elective surgeries and procedures to deferred routine care, patients will be seeking care at hospitals, urgent care centers, and physician offices in huge numbers. Couple that with new telehealth opportunities and potential sporadic COVID-19 outbreaks, and resources will be stretched thin.
Now is the time to investigate supportive third-party partnerships able to scale your coding and billing activities to meet the demand on a temporary basis or as a long-term strategy. Whether the current influx of COVID-19 patients has impacted your organization or you anticipate being swept along in the wave of post-coronavirus care, off-site support may be the flexible, expert help needed.
Remote Workforce Capabilities
Hospitals and providers are finding that the COVID-19 response is requiring many business functions to be provided remotely. Whether using existing staff members or engaging a trusted third-party partner, organizations using subscription-based software can continue their revenue cycle activities virtually uninterrupted.
Now is the time to ensure that your technological capabilities are shored up and operating efficiently. From prior authorizations to insurance verification and benefit eligibility to AR management, there are excellent and often integrated solutions available with near-immediate implementation.
As we continue to navigate the COVID-19 crisis, problems and opportunities will continue to present themselves. Now is the time for bold action to address revenue cycle issues through advanced technology and cutting-edge automation, ensuring sustainability into the future.
Contact us to learn more about how Infinx can help your revenue cycle during and after the COVID-19 pandemic.