Illustration COVID-19 virus.

How COVID-19 Is Affecting the Healthcare Revenue Cycle and More

The COVID-19 virus, otherwise known as Novel Coronavirus, has officially been declared a pandemic by the World Health Organization.

There are reported 125,000 cases globally and as of yesterday, it is roughly estimated that there are 1,200 cases in the US. This is having a great impact on healthcare providers in the United States as they are on the forefront of patient interactions. Providers and other healthcare workers are implementing emergency plans to handle the challenges surrounding their revenue cycle, billing and coding, patient financial responsibility and resource allocation.

Top Challenges for Your Healthcare Revenue Cycle

1) Ability to Respond

A continuously operational billing department is vital to keeping hospitals and practices open for individuals during this outbreak. Small practices are uncertain that they have enough disposable income to respond to the demands of COVID-19. In an effort to help, the Centers for Medicare and Medicaid services (CMS) has offered guidance on billing for the virus and what reimbursement opportunities exist for providers facing uncertainty. 

2) Billing and Coding

In an effort to ensure that US Healthcare facilities and clinical labs are prepared to respond, CMS has recently released two Healthcare Common Procedure Coding System (HCPCS) codes that laboratories can use to bill for certain COVID-19 diagnostic tests. CMS has also released guidance about billing surrounding the issue, answering questions about Medicare response and more. The AMA also announced that a new CPT® code has been created that streamlines novel coronavirus testing offered by hospitals, health systems and laboratories in the United States.

3) Patient Responsibility Balances

The COVID-19 outbreak is highlighting already pressing issues of patient financial responsibility and surprise medical billing. Healthcare providers are developing collection strategies and making other cost-sharing arrangements to combat this. Payers and providers are working together to lower out-of-pocket costs for people seeking testing and treatment. Congressional leaders have also agreed to an emergency spending deal that will authorize Medicare to waive geographical restrictions on telehealth.

Other Challenges Providers Are Facing:

1) Practice-Wide Staff Shortages

Practices and hospitals that are already short-staffed are struggling to keep up with the demand surrounding COVID-19. A growing concern is that hospitals and practices do not have enough manpower to take on the increasing number of patients entering their doors to get tested or seek treatment. Healthcare workers risk the exposure to the virus, as well as mental and physical exhaustion that’s often a result of working to support the demand and intake of patients.

2) Lack of Beds & Medical Supplies

The overwhelming response to COVID-19 is also impacting the healthcare system and its providers. There are shortages of staff, beds, space, facemasks and other critical resources. All of these issues compound each other’s severity. Even with full personal protective equipment, health care workers are becoming infected while treating patients with COVID-19. To aid healthcare professionals and hospitals, CDC has developed two checklists to prepare for patients with suspected or confirmed COVID-19. Determining how to allocate those resources in a way that meets the demand, but prevents halting operations is a huge challenge.

How Visit Alternatives Are Helping:

Improving access to care with Telehealth is just one way the healthcare industry aims to speed diagnosis and treatment and limit the risk of person-to-person exposure. This technology exists to help patients consult with their providers without having to leave their homes or possibly spread COVID-19 to those around them. Using Telehealth for care coordination can help protect patients and providers during public health emergencies.

The best thing your practice and you can do to make sure they are prepared for any further spread and growth of COVID-19 is to take preventative measures and steps to anticipate these challenges and work against them.



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