Tag: covid-19 impact on healthcare revenue cycles

6 Ways COVID-19 Has Impacted Healthcare Revenue Cycles in America

The COVID-19 pandemic has wreaked havoc on healthcare organizations across the United States.
But as some organizations are failing, others are thriving. By capitalizing on changes, and by training staff, organizations can optimize healthcare revenue cycles throughout the coronavirus pandemic.
Today, we’re highlighting five ways COVID-19 has impacted healthcare revenue cycles for organizations across the United States – and how organizations are thriving in the face of change.

Telehealth Appointments & Coding Challenges

Obviously, telehealth has surged in recent months. Many outpatient facilities have switched to telehealth appointments, giving patients the same quality of care via a safer, remote environment.
Telehealth appointments are also introducing coding and billing challenges. Some healthcare plans have updated policies for telehealth, while others have not. Medicare has introduced telehealth-related changes, for example, while other insurers are struggling to manage.
Meanwhile, some staff have inadequate training for telehealth billing. They bill patients when they should be billing healthcare plans, for example, or they’re charging inaccurate out-of-pocket payments and co-pays to providers. Some organizations have improper coding in place, complicating things further.

Remote Work

It’s not just patients accessing care remotely: staff are working remotely. Many organizations have requested billing and other support staff to work remotely throughout the pandemic.
Hennepin Healthcare in Minneapolis, for example, recently shifted nearly all support staff to remote positions, including coders, coding educators, coding auditors, coding support specialists, coding coordinators, and transcriptionists, as explained in an interview with HealthLeaders.
Remote work has introduced new challenges. Remote employees need to access company infrastructure to work, for example. Remote employees also need to consider HIPAA, taking extra care when managing patient data in an unfamiliar setting.
With employees using their own equipment, it introduces new challenges. IT departments across the country are struggling to keep up.

Billing & Coding Updates

There have been multiple billing and coding changes as a result of COVID-19. Good healthcare organizations are staying up-to-date on changes, while other healthcare organizations are lagging behind.
In April, the American Medical Association (AMA) announced it was fast-tracking the development of a unique Current Procedural Terminology (CPT) code for coronavirus testing.
CMS also released guidance on billing and reimbursement for treating COVID-19. CMS had previously released two Healthcare Common Procedure Coding System (HCPCS) codes, allowing labs to bill for certain COVID-19 diagnostic tests.
These changes can seem confusing, but good coding is the backbone of healthcare revenue cycle management.

Long-term Medicare Changes

As part of an $8.3 billion emergency funding measure passed earlier this year, Medicare now covers telehealth services. Healthcare organizations can receive payment from Medicare for telehealth appointments. Medicare covers video visits and similar telehealth appointments.
It’s possible this change is permanent: some experts suggest it will forever change the way we deliver healthcare.
When patients can access care without leaving their home, and when specialists can provide treatment from a remote setting, it changes the face of healthcare.

Postponed Elective Surgeries

Many patients have postponed elective surgeries due to concerns about coronavirus transmission in hospitals. Revenue cycle experts have also encouraged patients who can’t afford out-of-pocket costs to postpone elective procedures until they have a payment plan in place.
In April, CMS recommended that “all elective surgeries, non-essential medical, surgical, and dental procedures be delayed during the 2019 Novel Coronavirus (COVID-19) outbreak.”
Prior to that press release, organizations had already announced their own elective surgery policies.
Organizations across the country postponed elective surgeries to free up resources in preparation for a surge in cases.
All of these shifts have a significant impact on revenue cycles.

Increased Focus on Emergency Preparedness

Good healthcare organizations were prepared for this pandemic. They had emergency preparedness plans in place. They had previously established business continuity plans. Other organizations were less prepared: they were prepared for smaller emergencies or short-term surges, but they were not prepared for a months-long pandemic.
Revenue cycle management consultants can establish emergency preparedness plans for organizations. They can create business continuity guidance, helping firms navigate a complex, uncertain future while maintaining quality patient care and compliance.

Consider Hiring a Revenue Cycle Management Consultant

Revenue cycle management consultants are in high demand. Organizations across the United States are struggling to deal with the coronavirus pandemic – but some are thriving.
The difference between good and bad healthcare organizations is effective revenue cycle management. At HMI Corp, we specialize in revenue cycle management consulting. We highlight inefficiencies in your organization, then fix them.

Schedule a consultation with HMI Corp today. Discover effective revenue cycle management services that deliver a proven return on investment. We have 30+ years of experience helping small, medium, and large organizations optimize revenue cycles.

Healthcare Revenue Cycle Management and COVID-19: Coronavirus Impact & Management Strategies

97% of America’s healthcare organizations have experienced some disruption due to COVID-19.
As states re-open, healthcare organizations continue to navigate healthcare revenue cycle management. Some organizations are managing more effectively than others.
COVID-19 has introduced billing and coding challenges, patient financial responsibility issues, and other problems for healthcare organizations.
Today, we’re explaining strategies firms are using to manage revenue cycles during the COVID-19 pandemic – including how your organization can stay ahead.

Medical Coding Challenges

Many organizations have faced billing and coding challenges during the COVID-19 pandemic.
To navigate the pandemic, your organization needs to know what is covered by health plans for both inpatient and outpatient care.
Rules are changing constantly. That means staff require frequent training and regular updates to avoid billing and coding problems.
Many outpatient facilities are scheduling telehealth appointments, for example. Some insurance companies treat telehealth appointments the same way as in-person appointments. Others treat them differently. Check if the insurance company pays the same full rate for telehealth appointments. Check if the insurer needs further documentation or approvals.

Billing Challenges

Many healthcare organizations have shifted their billing office to work remotely. With some preparation, organizations can handle billing responsibilities from home.
To setup remote billing, an organization may need to give employees remote access. Employees may need to access certain systems and equipment to remain productive.
Employees also need to adhere to regulations – including privacy and data security. Working from home introduces new challenges with HIPAA, and your organization needs to address these challenges before compliance issues occur.

Business Continuity Issues

COVID-19 has made some healthcare organizations starkly aware of business continuity issues. Some organizations have strong emergency preparedness plans. Others do not.
Every healthcare organization has some type of emergency plan – but few healthcare organizations were prepared for a multi-month pandemic-related shutdown.
You may think it’s too late to address emergency preparedness for the coronavirus pandemic. However, nobody knows what happens next: a second wave later this year could be worse than the first wave. There’s no such thing as too much preparation.

Changes to Medicare

Several Medicare changes were introduced in recent weeks. Healthcare organizations need to review these changes and stay up-to-date on other upcoming changes.
Some of the biggest changes involve billable services, including services that can and cannot be billed under Medicare. Medicare allows billing for the treatment of uninsured patients with COVID-19, for example, or providing telehealth care.
Another big change is with Medicare cash flow: organizations can receive accelerated or advance payments from Medicare in certain situations, increasing cash flow at a time when needed most. By taking advantage of these cash flow changes, organizations can minimize COVID-19 disruptions.

Collecting from Patients

Patients are facing higher financial responsibilities during the coronavirus pandemic. Some patients are facing financial difficulties because their health plan lacks coverage for coronavirus-related bills.
Today is a great time to evaluate your organization’s collection and credit system. Each organization should evaluate its credit and collection policies. Pay close attention to changes in:
Copays and Deductibles: Some of America’s largest insurers have changed copay and deductible policies, including out-of-pocket responsibilities for patients.
Standard Referral Requirements: Consider standard referral requirements, as this can move payment obligations from the patient to the insurer.
By keeping staff trained and up-to-date on patient financial responsibility changes, healthcare organizations can optimize revenue cycles during the pandemic.

Other Things to Consider

Healthcare organizations are dealing with countless challenges during the coronavirus pandemic. Other things to consider with revenue cycle management include:
Capacity Assessment: Hospitals in many states are facing a surge in patients, including surges that overwhelm capacity. Your healthcare organization needs to develop proactive revenue cycle strategies to ensure you continue to meet patient needs when nearing capacity.
Staff Management: Your staff are on the front line of patient care. Has your organization created proactive plans for hours of operation, staffing and documentation requirements, telehealth accommodations, and other unique situations created by the coronavirus?

Hire a Consultant

There’s never been a better time to hire a revenue cycle management consultant. A good revenue cycle management consultant spots inefficiencies that impact revenue.
By implementing a consultant’s recommendations, your organization can thrive during the pandemic, surpassing revenue management cycle obligations and goals.
Revenue cycle management consulting is an investment. A good consultant firm provides a return on that investment, providing actionable recommendations that impact your firm’s revenue immediately.
At HMI Corp, we have offered revenue cycle management services since 1989. As a diversified healthcare company, we provide a spectrum of revenue cycle management services, including charge capture, chargemaster reviews, medical bill audits, and claims reviews.
Our clients include physician groups, large teaching hospitals, and organizations of all sizes in between. Contact us today to discover how we can help optimize revenue cycles for your organization. Our goal is to help you meet revenue goals while maintaining quality and compliance standards.

Final Word

The COVID-19 pandemic has introduced many challenges for healthcare organizations.
The situation is fluid, and it’s uncertain what happens next. However, organizations must continue to meet obligations and missions throughout the pandemic.
Using the strategies above, healthcare organizations can manage and thrive during the coronavirus pandemic, ensuring they meet revenue cycle goals.