COVID-19 has caused unprecedented challenges to the way populations operate. Healthcare has been at the front lines to manage the outbreak of the novel coronavirus. This is stressing the healthcare revenue cycle. COVID-19 brings new challenges around billing and coding, financial responsibility, resource allocation, and provider finances.

The stock market experienced its worst day since the financial crisis 12 years ago. Stocks dropped as a result of the global COVID-19 outbreak, and this has also affected healthcare providers. Major for-profit hospital systems, non-profit hospital systems, academic medical centers, and physician practices are facing financial challenges stemming from COVID-19, many still in the red today.

Stress on already-limited resources

Several studies show a fatality rate of 2.3 percent, with the mortality rate higher among the ill. This means the intensive services needed to treat patients is putting stress on already-limited resources. Many hospitals are running low on supplies like masks, ventilators, and personal protective equipment due to coronavirus. The government and payers are enabling providers to handle the new challenges by helping to alleviate new revenue cycle obstacles.

Medical billing and coding

Many companies have responded to this unusual situation. The American Medical Association (AMA) also announced earlier that the development of a unique Current Procedural Terminology (CPT) code is being made for reporting novel coronavirus testing. CMS has been helping providers handle the medical billing and coding aspects for testing and treatment of COVID-10. They released two Healthcare Common Procedure Coding System (HCPCS) codes for laboratory billing for COVID-19 tests, including tests developed in-house according to FDA guidelines. (https://www.ama-assn.org/press-center/press-releases/new-cpt-code-announced-report-novel-coronavirus-test)

Medical bills

Patient financial responsibility has been an issue during the outbreak as well. There are reports of patients being left with thousands of dollars in medical bills after seeking care for potential symptoms. Healthcare providers in the era of high-deductible health plans and other cost-sharing arrangements have had collection struggles, and it is even worse during an emergency. America’s Health Insurance Plans (AHIP) members announced they would “ease network, referral, and prior authorization requirements and/or waive patient cost-sharing” for physician-ordered testing for COVID-19.

Allocating resources

COVID-19 is also putting stress on a healthcare system that already has a heavy burden by overwhelming hospitals, emergency departments, and outpatient centers. Shortages of staff, space, and supplies make appropriately allocating resources difficult. Hospitals are taking steps to develop processes for decision making, planning for resources that may be in shortage, and involve clinical staff in developing strategies to address impacts.

Medicare patients

Steps have been taken for Medicare patients to assist them in telehealth services. Seniors who require checkups or doctor visits unrelated to potential coronavirus infections no longer need to travel to in-person clinics and expose themselves to potential infection. “Medicare beneficiaries across the nation, no matter where they live, will now be able to receive a wide range of services via telehealth without ever having to leave home,” said Seema Verma, the administrator of the Centers for Medicare and Medicaid Services. “And these services can also be provided in a variety of settings, including nursing homes, hospital outpatient departments, and more.” These telehealth benefits had previously been restricted to seniors living in rural areas who had already sought care through a particular provider.

Sunlit Cove Healthcare Consultants can assist you with telehealth setup, best practices, and the creation of policies and procedures to fit the specific telehealth needs in your practice. The future of telemedicine has arrived and we are here to provide a seamless transition!

Sunlit Cove Healthcare Consultants

We provide management and consulting services to help healthcare businesses run efficiently. Navigating the dynamic and complex revenue cycle management is a challenge for many health plans, health care vendors, and providers. Our consulting services are available to assist with your day-to-day operations and provide expertise in growth and change management. We manage all aspects of your enterprise from the development of the revenue cycle management process to the completion of your business cycle.

Related: Revenue Cycle Interim Management