As many as three million Americans found themselves unemployed in the first week of March as a result of the coronavirus pandemic. This has left many of the unemployed vulnerable, both clinically and financially, since we’ve seen very often that health insurance is tied to employment. Many with insurance too, are unsure of what their policy actually covers, and are concerned on the affordability of co-pays.
Hospitals, despite a busy workflow, are seeing a dip in their revenue, as a result of cancellation of many revenue generating services to accommodate COVID-19 patients. Even that revenue, at some point in time will be at risk, with patients struggling to pay. Operating at slim margins, many hospitals are seeing a significant rise in uncompensated care.
Amidst the chaos, determining rapid and accurate strategies to identify coverage for patients is very critical. It is essential that providers establish a collection process, which is empathetic towards distressed patients. At the same time they need to ensure that it is easy for the staff to manage a heavy workload of cases, while also dealing with the complexities of collection processes.
Automation to determine COVID-19 coverage
The current challenges can more or less be resolved by automating the coverage verification process. Her are five important tips
Expediting coverage checks for determining a changed case mix.
With the cancellation of selective procedures, hospitals most likely will see emergency admissions, and chances are that upfront coverage information may be missing. Adding to the confusion, determining changes to billing codes for added, amended and waived COVID-19 testing fees, plus finding out the collection process, makes this an excessively time consuming exercise. An automated tool can quickly verify the patient’s insurance status, and in accordance facilitate the staff to send the bills to relevant payors.
Limiting face-to-face contact during admissions
Maintaining social distancing during the admission process will ensure the safety of the hospital staff , with software running coverage checks on the arrival of the patient, it does away the need for lengthy in-person conversations. At the same time it enables staff to expeditiously process more admissions.
Determining missing coverage in the midst of constantly changing rules
It’s common to see patients changing plans or switching to Medicaid or Medicare, with unclear guidelines on who pays what, adding to the confusion. Despite the time it takes to determine government coverage, and commercial insurance, it prevents expensive write-off down the line. Automation to a large extent can scan through available coverage, and determine reimbursement options, making it easy for the patients.
Determining coverage information on telehealth services
With the importance of video and telephone-based platforms for routine care, billers find it difficult to determine if these calls are to be charged at the usual in-person rate or not. Automation facilitates billers to access payer updates, and verify upfront of any new guidelines for telehealth and virtual care, leveraging providers to charge in accordance.
Easing the staff workflow
With the front office staff that normally check payer websites currently choosing to stay indoors, or homeschooling their kids, or in quarantine themselves, staff productivity is bound to take a hit. Automation facilitates running high volume coverage checks, having a handful of staff.
Automation is key to the way forward
No one can dispute that automation expeditiously allows you to do more with less. In the current situation, it is imperative to access information needed to secure reimbursements, specifically concerning telehealth. BillingParadise, with a decade of experience and proven automated tools has helped health systems to streamline their billing process, optimise reimbursements, and improve revenue cycle.
