Keeping the Cash Flow Running

The severity of the COVID-19 crisis is making hospital staff work overtime in meeting unprecedented clinical and patient care demands and disruptions. No one can dispute the essentiality of these efforts, but hospitals also need to make sure that their revenue cycle operation stays robust in order to offset the economic implications arising out of the pandemic.

Adjusting financial projections could be one of the actions, as these would be indicative of the rapidly changing operational scenario, helping organizations plan and implement an alternative revenue cycle process that will help maintain the stability of the cash flow.

The revenue cycle staff of the hospital should be permitted to work from home, with appropriate safeguards. Also, enlisting trusted third parties to support key elements of the revenue cycle should be considered, especially account receivable management to prevent cash-flow disruptions.

In the course of reviewing operational concerns and setting plans to meet the anticipated financial impact of the COVID-19 pandemic, efforts should first begin with revising the financial performance targets, cash flow projections, and operational plans must indicate the following:

• The suspension time frame of high revenue generating elective surgeries
• The potential supply chain disruptions, and the impact of increased supply costs.
• The escalation of rising labor costs, as a result of extended operational demands.
• Taking into account equity losses, and the resultant investment income decline.
• Delayed reimbursements as a result of disruptions at the payer’s end

Among the necessary adjustments in financial projections, operational issues related to the COVID-19 outbreak, and the negative impact on cash flow and overall performance also need to be taken into account.

In particular:

• Educating coders in the use of COVID-19 related CPT and HSPCS codes for both private payers and government claims. In relation to the National Emergency declaration, Medicare has enlarged the scope of payments for professional services delivered through telehealth, virtual check-ins, and e-visits. Any inaccuracies related to COVID-19 coding may lead to denials and delayed payments, making it extremely difficult to resolve in the prevailing scenario.
• Interruptions in EDI services have been reported by some hospitals. It is critical that clearinghouse or bank electronic data interchange (EDI) functionalities are monitored by hospitals to ensure that 837 and 835 files containing claims and payment information continue to interchange between payers and providers. Any delays on timely claim submission or denial resolution will have a significant influence on collections.
• As a growing number of personnel suddenly finding themselves out of work, the hospital payer mix may likely shift rapidly. Claims will have to be frequently monitored by health systems, determining if Medicare and Medicaid volume is increasing and/or commercial reimbursement is falling. Budget projections can be severely impacted, due to these significant changes.
• As a result of limited staff availability at insurance company call centers, payer hold times for hospital staff working on denials have increased. Automation processes should be utilised, so that claims can be resolved without direct payer-provider interaction.
• In order to ensure up-to-date information regarding the status of unpaid claims, hospitals should work with payers to enable the receipt of 266/267 claim status files from clearing houses. The unpaid claims can also be tracked and monitored using payer portals.

The prevailing conditions have forced hospitals to cut-down non-critical staff, on-site staff, but they need to ensure that revenue cycle employees continue coding, filing claims, and handling account receivable follow-up from their homes, in order to keep the cash flow running.

In the process of setting up critical infrastructure elements needed to support secure, remote revenue cycle operations, the remote staff needs to supported with:

• EEfficient work-at-home platforms
• Secure & Encrypted platforms for data interchange
• Multifactor authentication

Laptops and remote workstations with internal encryption capabilities must be used to prevent risks of breach while transferring protected health information. Secure virtual private networks and multi-factor login authentication are equally important.

BillingParadise through an intelligent automation workflow transforms account receivable follow-ups to facilitate hospitals and health systems to expedite cash flow, and enhance operating margins, through a streamlined resolution of insurance claims

Hospitals and other providers have to make a decision if they intend moving their revenue staff to the home setting or not. An active consideration should also be weighed on partnering with a third-party, which has the capability of sharing their revenue cycle responsibilities, until the prevailing crisis comes to an end.

BillingParadise with a dedicated and experienced AR staff provides a comprehensive range of AR services. Be it for ageing claims resolution, denial management, and bad debt mitigation, our AR staff ensures that claims filed are accurate and successfully processed the very first time they are filed with payers. Most of our staff are currently working remotely on certified, secure, and encrypted platforms.

In addition, BillingParadise actively and effectively uses data analytics and intelligent automation for speeding up claim resolution. Most of our tools have been developed for remote access to facilitate organizations to continue their operations as usual, without any interruptions

Our capability also extends to rapidly handle  additional workflows. We can deploy our AR staff at short notice  to manage ageing AR and denials and prevent any cash flow disruptions, leveraging organizations and health systems to actively focus their attention on improving care for COVID-19 cases.

Contact us today to understand how our company can assist you sustain your organization’s cash flow in the ongoing COVID-19 crisis.